Recurrent Takotsubo Cardiomyopathy Related to Recurrent Thyrotoxicosis

Area of Science:

• Cardiology
• Endocrinology
• Internal Medicine

Background:

• Takotsubo cardiomyopathy (TTC), or transient left ventricular apical ballooning syndrome, involves acute left ventricular dysfunction without obstructive coronary artery disease.
• Recurrent episodes of TTC are uncommon, but cases have been reported in association with hyperthyroidism.

Observation:

• A 55-year-old woman experienced recurrent TTC, confirmed by repeat coronary angiography and left ventricular function assessments.
• These episodes coincided with recurrent hyperthyroidism linked to Graves disease.

Findings:

• Left ventricular function normalized in the patient after her thyroid function returned to normal following both TTC episodes.
• The study highlights a potential link between thyroid hormone excess and the pathophysiology of TTC in susceptible individuals.

Implications:

• These findings suggest that thyroid hormone excess may be a contributing factor in the development of takotsubo cardiomyopathy in some patients.
• Further research into the endocrine-cardiac interplay in TTC is warranted, particularly in managing patients with thyroid dysfunction.