Multiple sclerosis relapse presenting as an acute cardiomyopathy

Multiple sclerosis is increasingly being recognized in association with cardiovascular dysfunction, which can manifest with cardiomyopathy, pulmonary edema (Kaplan et al., 2015), orthostasis (Kaplan et al., 2015) and other complications. Takotsubo cardiomyopathy is a syndrome of acute-onset ventricular dysfunction in the absence of obstructive coronary artery disease, which on rare occasion has been observed in the setting of demyelinated plaques in the brainstem. We report on two cases of Takotsubo cardiomyopathy with medullary demyelination secondary to multiple sclerosis.