Key result
Stent-assisted coiling aids favorable recovery in severe reverse Takotsubo cardiomyopathy after subarachnoid hemorrhage.
Why the study?
Reverse Takotsubo cardiomyopathy is a rare variant in aneurysmal subarachnoid hemorrhage and its coexistence with neurogenic pulmonary edema has not been previously described.
Case Report (n=1)
This case highlights that reverse Takotsubo cardiomyopathy can co-occur with neurogenic pulmonary edema after aneurysmal subarachnoid hemorrhage, requiring complex, balanced hemodynamic management for favorable outcomes.
Takotsubo cardiomyopathy (TTC) is a recognized and potentially severe cardiac complication in patients with aneurysmal subarachnoid hemorrhage (aSAH).Reverse TTC (rTTC), a rare variant characterized by basal hypokinesis with apical sparing, is infrequently reported in this setting.The coexistence of rTTC with neurogenic pulmonary edema has not been previously described and represents a complex neurocardiac interaction that can significantly worsen outcomes.We report the case of a previously healthy 30-year-old man who presented with high-grade aSAH secondary to rupture of an anterior communicating artery aneurysm.His course was complicated by neurogenic pulmonary edema, refractory hypoxemia, hemodynamic instability, and rTTC.Management required early airway protection, bronchoscopy, vasopressor support, and complex stent-assisted endovascular coiling.Echocardiography demonstrated reduced left ventricular ejection fraction with basal hypokinesis and apical sparing, consistent with rTTC.Careful hemodynamic management was essential to balance cerebral perfusion against myocardial dysfunction.With multidisciplinary critical care and structured rehabilitation, the patient achieved favorable neurological and functional recovery.This case highlights that rTTC in aSAH is not a benign condition and may be associated with increased morbidity when combined with neurogenic pulmonary edema due to massive catecholamine surge.Early recognition using bedside echocardiography, prompt aneurysm securing, and balanced hemodynamic support are critical for improving outcomes.
No takes yet. Share an insight, caveat, or question.
Nainthramveetil et al. (2026) conducted a case report in Aneurysmal subarachnoid hemorrhage with reverse Takotsubo cardiomyopathy and neurogenic pulmonary edema (n=1). Stent-assisted endovascular coiling and multidisciplinary critical care was evaluated on Neurological and functional recovery. A 30-year-old man with aneurysmal subarachnoid hemorrhage, reverse Takotsubo cardiomyopathy, and neurogenic pulmonary edema achieved favorable recovery following stent-assisted endovascular coiling.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: