Takotsubo syndrome occurring concomitantly with pre-eclampsia: A case report

Area of Science:

• Cardiology
• Obstetrics & Gynecology
• Maternal-Fetal Medicine

Background:

• Takotsubo syndrome (TTS) is characterized by transient left ventricular dysfunction without coronary artery stenosis.
• Pregnancy-associated TTS is uncommon, with limited case reports available.
• Severe pre-eclampsia (PE) poses significant risks to both mother and fetus during gestation.

Observation:

• A 35-week pregnant woman presented with dyspnea and severe pre-eclampsia.
• Cardiac ultrasound revealed anterior lower wall akinesis, consistent with TTS.
• An emergent cesarean section was performed due to fetal distress, resulting in a neonate with severe acidosis.

Findings:

• The patient was diagnosed with Takotsubo syndrome occurring concurrently with severe pre-eclampsia.
• Post-delivery, the patient's cardiac function significantly improved, and coronary angiography confirmed no coronary artery stenosis.
• This case represents the seventh reported instance of antenatal TTS, with three of these complicated by severe PE.

Implications:

• Antenatal Takotsubo syndrome, particularly when complicated by severe pre-eclampsia, may carry a critical risk for fetal well-being.
• While maternal outcomes in pregnancy-associated TTS are generally favorable, severe PE introduces significant fetal jeopardy.
• Further research is warranted to elucidate the pathophysiology and optimize management strategies for TTS in pregnancy, especially with concurrent severe PE.