Vol 16, No 4 (2021)
Case report
Published online: 2021-08-31
Late-onset takotsubo cardiomyopathy after acute pulmonary embolism
Folia Cardiologica 2021;16(4):248-251.
Abstract
Takotsubo syndrome (TTS) is an acute condition characterized by transient decrease of regional contractility most often involving apical segments of left ventricle. We present the case report of 87-year old woman diagnosed with intermediate-high risk acute pulmonary embolism, previously discharged in a stable condition, who was presented again to the Emergency Department because of a syncope and increasing levels of troponin. After differential diagnostics including coronaroangiography and transthoracic echocardiography complemented by the longitudinal strain assessment with the use of speckle tracking echocardiography a diagnosis of takotsubo cardiomyopathy was made. This case shows the significance of strain echocardiography in diagnostics of TTS.
Keywords: takotsubo cardiomyopathyacute pulmonary embolismstress cardiomyopathystrain echocardiography
References
- Rudski LG, Lai WW, Afilalo J, et al. Guidelines for the echocardiographic assessment of the right heart in adults: a report from the American Society of Echocardiography endorsed by the European Association of Echocardiography, a registered branch of the European Society of Cardiology, and the Canadian Society of Echocardiography. J Am Soc Echocardiogr. 2010; 23(7): 685–713; quiz 786.
- Ono R, Falcão LM. Takotsubo cardiomyopathy systematic review: pathophysiologic process, clinical presentation and diagnostic approach to Takotsubo cardiomyopathy. Int J Cardiol. 2016; 209: 196–205.
- Ghadri JR, Wittstein IS, Prasad A, et al. International Expert Consensus Document on Takotsubo Syndrome (Part I): Clinical Characteristics, Diagnostic Criteria, and Pathophysiology. Eur Heart J. 2018; 39(22): 2032–2046.
- Jin Qi, Luo Q, Zhao Z, et al. Takotsubo syndrome with pulmonary embolism: a case report and literature review. BMC Cardiovasc Disord. 2018; 18(1): 229.
- Petrov IS, Tokmakova MP, Marchov DN, et al. Is everything clear about Tako-tsubo syndrome? Folia Med (Plovdiv). 2011; 53(2): 5–12.
- Medina de Chazal H, Del Buono MG, Keyser-Marcus L, et al. Stress cardiomyopathy diagnosis and treatment: JACC state-of-the-art review. J Am Coll Cardiol. 2018; 72(16): 1955–1971.
- Jurisic S, Gili S, Cammann V, et al. Clinical predictors and prognostic impact of recovery of wall motion abnormalities in takotsubo syndrome: results from the International Takotsubo Registry. J Am Heart Assoc. 2019; 8(21).
- Eitel I, von Knobelsdorff-Brenkenhoff F, Bernhardt P, et al. Clinical characteristics and cardiovascular magnetic resonance findings in stress (takotsubo) cardiomyopathy. JAMA. 2011; 306(3): 277–286.
- Citro R, Piscione F, Parodi G, et al. Role of echocardiography in takotsubo cardiomyopathy. Heart Failure Clinics. 2013; 9(2): 157–166.
- Citro R, Okura H, Ghadri JR, et al. EACVI Scientific Documents Committee. Multimodality imaging in takotsubo syndrome: a joint consensus document of the European Association of Cardiovascular Imaging (EACVI) and the Japanese Society of Echocardiography (JSE). Eur Heart J Cardiovasc Imaging. 2020; 21(11): 1184–1207.