Aims and objectives
Takotsubo cardiomyopathy (TCM) is characterized by transient apical dysfunction of the ventricle typically induced by stress,
without evidence of obstructive coronary disease.
Acute cerebrovascular events including ischemic (IS) or hemorrhagic (HE) stroke may be associated with an important release of catecholamines.
The aim of our work was to identify the typical characteristics and outcomes of patients who presented Takotsubo syndrome pictures in the course of IS or HE.
Methods and materials
Between 2009 and 2018,
we had 17 patients in TCM intensive care.
5 of these patients had an IS or HE in the previous 4 days.
Takotsubo syndrome was diagnosed with cardiac magnetic resonance,
electrocardiography (ECG) and coronary angiography.
Three women and two men were included in the study.
The mean age was 63.7 ± 20.1 years (range 44-84).
Three patients (60%) initially presented an IS while two (40%) such as HE.
Cerebral ischemic outbreaks were found in the insular site for 2 patients and in the posterior fossa for 1 patient.
aphasia and cerebellar symptoms were the main reported neurological signs.
In the two HE cases we found an aneurysm of anterior and right posterior communicating arteries.
Abnormal ECG findings including ST segment elevation (33%) or T-wave inversion (50%) at 48 hours after initiation of IS or HE were indicative of ongoing...
many authors describe TCM as an event that could develop in the first days after a stroke.
It occurs predominantly in women with lesions of the posterior cranial fossa or in the insular site,
or in the presence of a ruptured intracranial aneurysm with hemorrhage,
in response to abnormal vegetative reactions from catecholamine increment.
TCM is one of many disorders with heart-brain interaction and an understanding of its pathology can shed light on the complex interactions between the brain,
the sympathetic nervous system and the...
Interventional and Vascular Radiology
1: Muthachen NR,
Anesthetic management of a patient with Takotsubo cardiomyopathy presenting for surgical clipping of intracranial aneurysm.
J Anaesthesiol Clin Pharmacol.
PubMed PMID: 29416253; PubMed Central PMCID: PMC5791274.
2: Hayashi H,
Reversible Left Ventricular Wall Thickening with Takotsubo Syndrome Sequentially Detected by Cardiac Magnetic Resonance Imaging.
2018 Feb 15;57(4):517-522.