scholarly journals A Case Report of Recurrent Takotsubo Cardiomyopathy in a Patient during Myasthenia Crisis

2017 ◽  
Vol 2017 ◽  
pp. 1-5
Author(s):  
Anusha Battineni ◽  
Naresh Mullaguri ◽  
Shail Thanki ◽  
Anand Chockalingam ◽  
Raghav Govindarajan
Keyword(s):  
Case Report ◽  
Takotsubo Cardiomyopathy ◽  
Stress Cardiomyopathy ◽  
Cardiac Monitoring ◽  
Grave’S Disease ◽  
Grave's Disease ◽  
St Elevation ◽  
Artery Disease ◽  
One Year ◽  
High Level

Introduction. Patients with myasthenia crisis can develop Takotsubo stress cardiomyopathy (SC) due to emotional or physical stress and high level of circulating catecholamines. We report a patient who developed recurrent Takotsubo cardiomyopathy during myasthenia crisis. Coexisting autoimmune disorders known to precipitate stress cardiomyopathy like Grave’s disease need to be evaluated. Case Report. A 69-year-old female with seropositive myasthenia gravis (MG), Grave’s disease, and coronary artery disease on monthly infusion of intravenous immunoglobulin (IVIG), prednisone, pyridostigmine, and methimazole presented with shortness of breath and chest pain. Electrocardiogram (ECG) showed ST elevation in anterolateral leads with troponemia. Coronary angiogram was unremarkable for occlusive coronary disease with left ventriculogram showing reduced wall motion with apical and mid left ventricle (LV) hypokinesis suggestive of Takotsubo stress cardiomyopathy. Her symptoms were attributed to MG crisis. Her symptoms, ECG, and echocardiographic findings resolved after five cycles of plasma exchange (PLEX). She had another similar episode one year later during myasthenia crisis with subsequent resolution in 10 days after PLEX. Conclusion. Takotsubo cardiomyopathy can be one of the manifestations of myasthenia crisis with or without coexisting Grave’s disease. These patients might benefit from meticulous fluid status and cardiac monitoring while administering rescue treatments like IVIG and PLEX.

Atypical Takotsubo Cardiomyopathy with Hypokinetic Left Mid-ventricle and Apical Wall Sparing: A Case Report and Literature Review

2020 ◽  
Vol 16 (3) ◽  
pp. 241-246
Author(s):  
Dipesh Ludhwani ◽  
Belaal Sheikh ◽  
Vasu K Patel ◽  
Khushali Jhaveri ◽  
Mohammad Kizilbash ◽  
...  
Keyword(s):  
Case Report ◽  
Takotsubo Cardiomyopathy ◽  
Systolic Dysfunction ◽  
Obstructive Coronary Artery Disease ◽  
Left Ventricular ◽  
Reduced Ejection Fraction ◽  
Coronary Syndrome ◽  
Normal Left Ventricular ◽  
Artery Disease

Background: Takotsubo Cardiomyopathy (TTC) is an uncommon cause of acute reversible ventricular systolic dysfunction in the absence of obstructive Coronary Artery Disease (CAD). Typically manifesting as apical wall ballooning, TTC can rarely present atypically with apical wall sparing. Case report: A 62-year-old female presented with complaints of chest pain and features mimicking acute coronary syndrome. Coronary angiogram revealed no obstructive CAD and left ventriculogram showed reduced ejection fraction, normal left ventricular apex and hypokinetic mid-ventricles consistent with atypical TTC. The patient was discharged home on heart failure medications and a follow-up transthoracic echocardiogram demonstrated improved left ventricular function with no wall motion abnormality. Conclusion: This case report provides an insight into the diagnosis and management of TTC in the absence of pathognomic features.

Takotsubo cardiomyopathy: a novel beta-adrenergic blocker withdrawal syndrome

2013 ◽  
Vol 154 (7) ◽  
pp. 267-271 ◽  
Author(s):  
János Tomcsányi ◽  
Kinga Jávor ◽  
Hrisula Arabadzisz ◽  
András Zsoldos ◽  
Vince Wagner ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Takotsubo Cardiomyopathy ◽  
Cardiac Dysfunction ◽  
Drug Withdrawal ◽  
Beta Blockers ◽  
Stress Cardiomyopathy ◽  
Abrupt Withdrawal ◽  
Adrenergic Blocker ◽  
Artery Disease ◽  
Long Acting

The authors describe two cases of takotsubo cardiomyopathy developing after an abrupt withdrawal of carvedilol and bisoprolol. Takotsubo or stress cardiomyopathy is characterized by acute and reversible cardiac dysfunction without coronary artery disease. It is triggered by acute emotional or physical stress, drugs or drug withdrawal. The immediate discontinuation of the long acting vasodilator beta-blocker, carvedilol has not yet been described to cause takotsubo cardiomyopathy. The authors recommend cautious withdrawal of beta-blockers. Orv. Hetil., 2013, 154, 267–271.

scholarly journals Electrocardiographic Abnormalities of Takotsubo Cardiomyopathy in a Patient with Paced Ventricular Rhythm

2010 ◽  
Vol 2010 ◽  
pp. 1-3 ◽  
Author(s):  
Krati Chauhan ◽  
Siva P. Sontineni ◽  
Venkata M. Alla ◽  
Mark J. Holmberg
Keyword(s):  
Takotsubo Cardiomyopathy ◽  
Significant Coronary Artery Disease ◽  
Regional Wall Motion ◽  
T Wave ◽  
Wave Inversion ◽  
Qt Interval Prolongation ◽  
Regional Wall Motion Abnormalities ◽  
St Elevation ◽  
Wall Motion Abnormalities ◽  
Artery Disease

Takotsubo cardiomyopathy (TCM) is a unique cardiomyopathy characterized by chest pain, ECG, and regional wall motion abnormalities closely mimicking acute myocardial infarction, in the absence of significant coronary artery disease. Classic ECG changes of TCM include ST elevation or T wave inversion. However, ECG abnormalities of TCM in patients with paced ventricular rhythms have not been well characterized. Herein, we report the case of an 85-year-old pacemaker dependant female who was diagnosed with TCM four weeks following the demise of her husband. Abnormal negative T wave concordance in precordial leads and QT interval prolongation were the only new ECG findings and these reverted back to baseline on followup.

Management of airway obstruction with nebulised adrenaline resulting in takotsubo cardiomyopathy: case report

2016 ◽  
Vol 130 (9) ◽  
pp. 883-886 ◽  
Author(s):  
F Keshtkar ◽  
O T Dale ◽  
W O Bennett ◽  
C E Hall
Keyword(s):  
Case Report ◽  
Airway Obstruction ◽  
Takotsubo Cardiomyopathy ◽  
Apical Ballooning ◽  
Left Ventricular ◽  
Coronary Syndrome ◽  
Wave Inversion ◽  
Acute Airway Obstruction ◽  
Artery Disease ◽  
High Index Of Suspicion

AbstractBackground:Takotsubo cardiomyopathy has been associated with the use of catecholamines; however, its development after the use of nebulised adrenaline for the management of acute airway obstruction has not previously been described.Case report:A 66-year-old man with squamous cell carcinoma of the larynx, with tumour–node–metastasis staging of T3N2cM0, confirmed by biopsy and computed tomography, presented to the emergency department with acute airway obstruction. He was treated twice with nebulised adrenaline and intravenous dexamethasone. After a period of 24 hours, cardiac rhythm changes were noted on telemetry. A 12-lead electrocardiogram showed widespread T-wave inversion and QT prolongation suggestive of an acute coronary syndrome. Coronary angiography demonstrated no coronary artery disease, but left ventricular angiography showed marked apical ballooning and apical wall akinesia consistent with a diagnosis of takotsubo cardiomyopathy.Conclusion:Takotsubo cardiomyopathy can mimic true ischaemic heart disease and the diagnosis requires a high index of suspicion in patients managed with nebulised adrenaline.

Takotsubo cardiomyopathy associated with dydrogesterone use

2021 ◽  
Vol 14 (11) ◽  
pp. e246553
Author(s):  
Adam Ioannou
Keyword(s):  
Coronary Artery Disease ◽  
Case Report ◽  
Coronary Artery ◽  
Takotsubo Cardiomyopathy ◽  
Premenopausal Woman ◽  
Apical Ballooning ◽  
Left Ventricular ◽  
Female Sex Hormones ◽  
First Case ◽  
Artery Disease

Takotsubo cardiomyopathy is characterised by left ventricular apical ballooning, in the absence of coronary artery disease, and classically occurs at times of intense stress. Due to the striking preponderance of Takotsubo cardiomyopathy occurring in postmenopausal women, it has been postulated that female sex hormones may also be implicated in its pathogenesis. This case report describes the first case of Takotsubo cardiomyopathy associated with the initiation of dydrogesterone (a synthetic retroprogesterone) in a premenopausal woman.

Persistent hyperthyroidism in a patient after total thyroidectomy: the thyroid anatomy has implications for treatment

2021 ◽  
Vol 19 (2) ◽  
pp. 186-188
Author(s):  
Aleksandra Młodożeniec ◽  
◽  
Agnieszka Gala-Błądzińska ◽  
◽  
Keyword(s):  
Nuclear Medicine ◽  
Case Report ◽  
Total Thyroidectomy ◽  
Radioactive Iodine ◽  
Radioactive Iodine Therapy ◽  
Thyroid Scintigraphy ◽  
Grave’S Disease ◽  
Grave's Disease ◽  
Pyramidal Lobe ◽  
Tracer Accumulation

Introduction. Grave’s disease (GD) can be treated using three modalities: anti-thyroid medications, radioactive iodine therapy (RAI), or surgery. If surgery is selected, total thyroidectomy is the procedure of choice. Patients with hyperthyroidism frequently have an enlarged thyroid gland, occasionally with a pyramidal lobe. Aim. We point the usefulness of thyroid scintigraphy, which provides valuable information regarding the thyroid anatomy. Description of the case. The manuscript presents a case report of 43-year-old woman with unstable Grave’s disease, who underwent thyroidectomy and developed persistent hyperthyroidism postoperatively. She was referred by an endocrinologist to a nuclear medicine outpatient clinic for RAI therapy. I-iodide scintigraphy revealed two foci with excessive tracer accumulation. One of the foci in the middle of the neck corresponded to the pyramidal lobe. Conclusion. The thyroid anatomy anomalies can lead to unnecessary implications for treatment. Identifying the pyramidal lobe preoperatively and removing it from patients requiring total thyroidectomy may decrease the recurrence rate of hyperthyroidism. Thyroid scintigraphy is a useful diagnostic tool to visualize the pyramidal lobe.

Grave’s disease associated with myasthenia gravis: a case report

2014 ◽  
Vol 2 (1) ◽  
pp. 4 ◽  
Author(s):  
Abdoulaye Pouye ◽  
Diatou Guèye Dia ◽  
Souhaibou Ndongo ◽  
Atoumane Faye ◽  
Nafissatou Diagne Sakho ◽  
...  
Keyword(s):  
Case Report ◽  
Myasthenia Gravis ◽  
Grave’S Disease ◽  
Grave's Disease
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