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Stress-Induced Takotsubo Cardiomyopathy After Transjugular Intrahepatic Portosystemic Shunt

Bernadette Lamb1, Benjamin Arbeiter1, Neil Bhogal2

  • 1Department of Internal Medicine, University of Nebraska Medical Center, Omaha, NE.

ACG Case Reports Journal
|July 2, 2020
PubMed

Insights

This case report details Takotsubo cardiomyopathy, a form of heart failure, following a transjugular intrahepatic portosystemic shunt procedure. The patient recovered fully with medical treatment, highlighting a potential complication of the procedure.

Area of Science:

  • Cardiology
  • Hepatology
  • Interventional Radiology

Background:

  • Transjugular intrahepatic portosystemic shunt (TIPS) procedures are common for managing complications of portal hypertension.
  • Cirrhotic cardiomyopathy is a known complication in patients with advanced liver disease.
  • Takotsubo cardiomyopathy, or stress-induced cardiomyopathy, is typically associated with emotional or physical stress.

Observation:

  • A 59-year-old woman with decompensated cirrhosis developed new-onset heart failure post-TIPS.
  • The patient had no prior history of cardiovascular disease or cirrhotic cardiomyopathy.
  • Echocardiography revealed transient left ventricular systolic dysfunction.

Findings:

  • This is the first documented case of Takotsubo cardiomyopathy occurring after a TIPS procedure.
  • The patient's heart function recovered within two weeks of medical management.
  • Treatment involved beta-blockers and diuretics.

Implications:

  • Takotsubo cardiomyopathy should be considered in patients presenting with new-onset heart failure after TIPS.
  • Further research is needed to understand the mechanism linking TIPS and Takotsubo cardiomyopathy.
  • This case highlights the importance of comprehensive cardiovascular monitoring in patients undergoing TIPS.

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