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Another Way to Break Hearts: Reverse Takotsubo Cardiomyopathy
Yixin Zhang1, Swetha R Nuthulaganti1, Kevin Liu2
1Internal Medicine, University of Florida College of Medicine - Jacksonville, Jacksonville, USA.
Cureus
|June 2, 2022
Summary
A rare case of reverse Takotsubo cardiomyopathy occurred after surgery, presenting as cardiac arrest. Prompt treatment led to full cardiac function recovery, showing stress-induced cardiomyopathy can be temporary.
Area of Science:
- Cardiology
- Cardiovascular Medicine
- Critical Care Medicine
Background:
- Takotsubo cardiomyopathy (TTC) is a stress-induced condition affecting the heart.
- Reverse TTC is a less common variant, often presenting atypically.
Observation:
- A 34-year-old female developed hypoxia, ventricular fibrillation, and cardiac arrest post-intubation.
- Coronary arteries were normal; CT angiogram revealed pulmonary embolism.
- Transthoracic echocardiogram showed reduced ejection fraction and basal wall akinesis, indicative of reverse TTC.
Findings:
- The patient achieved return of spontaneous circulation (ROSC) after resuscitation and was treated with anticoagulation.
- Cardiac MRI one week later demonstrated a recovered left ventricular ejection fraction.
- This case highlights variants of TTC and the transient nature of stress-induced cardiac dysfunction.
Implications:
- Acute physiological stressors can temporarily impair cardiac function.
- Early recognition and management of TTC variants are crucial for patient outcomes.
- Pulmonary embolism can be a co-occurring condition or trigger in cardiac emergencies.
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