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Magnetic Resonance Imaging of Multiple Sclerosis at 7.0 Tesla
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Multiple sclerosis broke my heart.

Géraldine Androdias1,2, Emilien Bernard3, Damien Biotti4

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Acute heart failure can be a rare complication of multiple sclerosis relapses. This takotsubo cardiomyopathy in multiple sclerosis patients resolved quickly with corticosteroid treatment.

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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.