Takotsubo Syndrome and Cerebral Cardioembolism: Case Report to Redefine the Short-term Prognosis
Keywords:Takotsubo, stroke, cardiac embolism
Takotsubo cardiomyopathy is characterized by transient hypo-kinesis of the left ventricular apex or midventricular segments, without significant stenosis affecting coronary arteries. This cardiomyopathy is well known to be related to cerebral infarction, although scarce data describe the real timing of this adverse event.
We report the case of a 69-year-old woman who experienced Takotsubo cardiomyopathy, and developed cardiogenic cerebral embolism on the fourth day from the onset of symptoms.Takotsubo patients could be effectively at high risk for stroke; thus, we should pay attention to rule out ventricular thrombosis, consider immediately anticoagulant therapy, and revise Takotsubo prognosis because its complications.
Kurisu S, Kihara Y. Tako-tsubo cardiomyopathy: clinical presentation and underlying mechanism. J Cardiol. 2012 Dec;60(6):429-37. doi: 10.1016/j.jjcc.2012.06.015. Epub 2012 Oct 15.
De Boer D, Ring C, Wood M, Ford C, Jessney N, McIntyre D, Carroll D. Timecourse and mechanisms of mental stress-induced changes and their recovery: hematocrit, colloid osmotic pressure, whole blood viscosity, coagulation times, and hemodynamic activity. Psychophysiology 2007;44:639e649.
Ajmani RS, Fleg JL, Demehin AA, Wright JG, O’Connor F, Heim JM, Tarien E, Rifkind JM. Oxidative stress and hemorheological changes induced by acute treadmill exercise. Clin Hemorheol Microcirc 2003;28:29e40.
Bielecka-Dabrowa A, Mikhailidis DP, Hannam S, Rysz J, Michalska M, Akashi YJ, Banach M. Takotsubo cardiomyopathy—the current state of knowledge. Int J Cardiol 2010;142:120e125.
Cecchi E, Parodi G, Giglioli C, Passantino S, Bandinelli B, Liotta AA, Bellandi B, Cioni G, Costanzo M, Abbate R, Gensini GF, Antoniucci D, Mannini L.Stress-induced hyperviscosity in the pathophysiology of takotsubo cardiomyopathy.Am J Cardiol. 2013 May 15;111(10):1523-9. doi: 10.1016/j.amjcard.2013.01.304.
De Gregorio C, Grimaldi P, Lentini C. Left ventricular thrombus formation and cardioembolic complications in patients with Takotsubo-like syndrome: a systematic re- view. Int J Cardiol 2008;131:18-24.
Yoshimura S, Toyoda K, Ohara T, et al. Takotsubo cardio- myopathy in acute ischemic stroke. AnnNeurol 2008; 64:547-554.
Jabiri MZ, Mazighi M, Meimoun P, et al. Tako-tsubo syndrome: a cardioembolic cause of brain infarction. CerebrovascDis 2010;29:309-310.
Kim SM, Aikat S, Bailey A, White M. Takotsubo cardiomyopathy as a source of cardioembolic cerebral infarction. BMJ Case Rep. 2012 Sep 21;2012. pii: bcr2012006835. doi: 10.1136/bcr-2012-006835.
Matsuzono K, Ikeda Y, Deguchi S, Yamashita T, Kurata T, Deguchi K, Abe K. Cerebral embolic stroke after disappearing takotsubo cardiomyopathy. J Stroke Cerebrovasc Dis. 2013 Nov;22(8):e682-3. doi: 10.1016/j.jstrokecerebrovasdis.2013.07.022. Epub 2013 Aug 15.
Shewan LG, Coats AJS, Henein M. Requirements for ethical publishing in biomedical journals. International Cardiovascular Forum Journal 2015;2:2 DOI: 10.17987/icfj.v2i1.4
Authors who publish with this journal agree to the following terms:
a. The authors will retain copyright under a Creative Commons Attribution License (CC-BY 4.0) that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
b. Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
c. Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work (See The Effect of Open Access).