Multiple sclerosis broke my heart

Area of Science:

• Neurology
• Cardiology

Background:

• Multiple sclerosis (MS) is a chronic demyelinating disease affecting the central nervous system.
• Acute heart failure (AHF) is a serious condition requiring prompt medical attention.

Purpose of the Study:

• To report and characterize cases of AHF associated with multiple sclerosis relapses.
• To investigate the potential link between MS relapses and cardiac dysfunction.

Main Methods:

• Case series reporting 5 patients with MS relapses and AHF.
• Clinical assessment, echocardiography, and brain MRI were utilized.
• Treatment with intravenous corticosteroids was administered.

Main Results:

• Five patients experienced AHF during MS relapses, with 3 presenting AHF as the initial symptom.
• AHF was severe, requiring intensive care, and associated with brainstem dysfunction and new medullary lesions on MRI.
• Echocardiography revealed left ventricular hypokinesis.
• No other cause for AHF was identified.
• All patients showed complete recovery of cardiac function after corticosteroid treatment.

Conclusions:

• MS relapses can trigger a takotsubo-like phenomenon, leading to AHF.
• Physicians should consider takotsubo cardiomyopathy in MS patients presenting with AHF, especially during relapses.
• Prompt recognition and treatment with corticosteroids can lead to favorable cardiac outcomes.