Key result
Conservatively managed myasthenia gravis crisis linked to Tako-tsubo cardiomyopathy without plasmapheresis.
Why the study?
The association of tako-tsubo cardiomyopathy with myasthenia gravis crisis is rare and not well understood, with few reported cases.
Case Report (n=1)
Patients with myasthenia gravis crisis may be at risk for Tako-tsubo cardiomyopathy even without plasmapheresis, warranting careful clinical and electrocardiographic monitoring.
May warrant monitoring for Tako-tsubo in myasthenia gravis crisis without plasmapheresis; hypothesis-generating case report leaves association open.
Tako-tsubo cardiomyopathy (TTC) is increasingly being recognised as transient left ventricular dysfunction following various hyperadrenergic states such as emotional or physical stressors. The association of this rare clinical entity with myasthenia gravis (MG) has been reported only twice in the literature, both following plasmapheresis for MG crisis. Here we describe a unique case of TTC in a 40-year-old woman with MG admitted with MG crisis managed conservatively. This case suggests that plasmapheresis is unlikely to have a causative role in the development of TTC in these patients. Patients with MG crisis may be at potential risk of developing TTC and careful clinical and electrocardiographic monitoring is necessary while treating them. The possible role of stress as the common precipitating factor in both conditions is also discussed.
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Sasidharan et al. (2009) conducted a case report in Tako-tsubo cardiomyopathy and myasthenia gravis crisis (n=1). Myasthenia gravis crisis was evaluated on Development of Tako-tsubo cardiomyopathy. A 40-year-old woman developed Tako-tsubo cardiomyopathy during a conservatively managed myasthenia gravis crisis, suggesting plasmapheresis is not required for its development.
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