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Takotsubo cardiomyopathy-related complete heart block and torsades de pointes

Faisal Inayat1, Hafeez Ul Hassan Virk2, Waqas Ullah3

  • 1New York-Presbyterian Hospital, Weill Cornell Medical College, New York City, New York, USA.

BMJ Case Reports
|July 16, 2017
PubMed

Insights

Takotsubo cardiomyopathy (TCM), a condition mimicking heart attacks, can rarely cause life-threatening arrhythmias like torsades de pointes. This case highlights the critical need for vigilant monitoring and management of these rare but severe complications.

Area of Science:

  • Cardiology
  • Internal Medicine
  • Clinical Research

Background:

  • Takotsubo cardiomyopathy (TCM) is a recognized cause of acute heart dysfunction.
  • It often presents similarly to acute coronary syndrome but without obstructive coronary artery disease.
  • While generally reversible with a good prognosis, rare complications exist.

Observation:

  • A patient with TCM developed complete atrioventricular block.
  • This was followed by QT prolongation, a risk factor for arrhythmias.
  • The patient subsequently experienced torsades de pointes, a dangerous ventricular arrhythmia.

Findings:

  • This case illustrates a rare but severe arrhythmic complication of Takotsubo cardiomyopathy.
  • The patient experienced a sequence of conduction abnormalities and ventricular arrhythmias.
  • A literature review confirmed the rarity and challenges in managing these events.

Implications:

  • Takotsubo cardiomyopathy can have life-threatening arrhythmic complications beyond typical presentations.
  • Complete atrioventricular block and QT prolongation may precede dangerous arrhythmias in TCM.
  • Effective management strategies for these rare complications require further investigation and clinical attention.

Keywords:
arrhythmiaspacing and electrophysiology

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