Tako-Tsubo Cardiomyopathy Associated with Seizures
Rent the article at a discountRent now
* Final gross prices may vary according to local VAT.Get Access
Takotsubo syndrome is a reversible neuromyocardial failure that has been thought to be related to an acute catecholamine toxicity of the myocardium brought upon by a stressful event. The neurocritical care unit population is particularly vulnerable for this condition given the acute presentation of neurological emergencies, which most often can be catastrophic. We present a case series of this syndrome and a review of the literature.
Our recent experience with three cases that were prospectively identified with the diagnosis of Takotsubo syndrome is reported with clinical presentation, evaluation, and management approach. Review of the literature is presented in the discussion.
We present three episodes of Takotsubo neuromyocardial syndrome in two patients that were admitted to our neurointensive care unit that presented with seizures and had typical clinical presentation, echocardiographic and cardiac catheterization findings. All the episodes were treated with vasoactive medications, ventilatory support, afterload and preload reduction, and treatment of the underlying condition. There was complete reversal of their symptoms and findings in each episode.
Patients with critical neurological illnesses such as large ischemic or hemorrhagic stroke, status epilepticus, recurrent seizure activities as in our study may be at a higher risk for Takotsubo neuromyocardial syndrome.
- Abdulla I, Kay S, Mussap C, Nelson GIC, Rasmussen HH, Hansen PS, et al. Apical sparing in tako-tsubo cardiomyopathy. Int Med J. 2006;37:414–8. CrossRef
- Akashi YJ, Nakszawa K, Sakakibara M, Mitake F, Koike H, Sasaka K. The clinical features of takotsubo cardiomyopathy. Q J Med. 2003;96:563–73.
- Akashi YJ, Musha H, Nakszawa K, Miyake F. Plasma brain natriuretic peptide in takotsubo cardiomyopathy. Q J Med. 2003;97(9):599–607.
- Azzarelli S, Galassi AR, Amico F, Giacoppo M, Argentino V, Tomasello SD, et al. Clinical features of transient left ventricular apical ballooning. Am J Cardiol. 2006;98:1273–6. CrossRef
- Bybee KA, Kara T, Prasad A, Lerman A, Barsness GW, Wright RS, et al. Systematic review: transient left ventricular apical ballooning: a syndrome that mimics ST-segment elevation myocardial infarction. Ann Intern Med. 2004;141:858–65.
- Bennett JR, McCarty D, Wilson CM, O’Neil F. Takotsubo cardiomyopathy: an uncommon cause of ST segment elevation. Intensive Care Anesth. 2007;62:279–81.
- Berman M, Saute M, Porat E, Vaturi M, Paul-Kislin L, Vidne A, et al. Takotsubo cardiomyopathy: expanding the differential diagnosis in cardiothoracic surgery. Ann Thorac Surg. 2007;83:295–8. CrossRef
- Buchholz S, Rudan G. Tako-tsubo syndrome on the rise: a review of the current literature. Postgrad Med J. 2007;83:261–4. CrossRef
- Cheng TO. Takotsubo cardiomyopathy represents a stress induced myocardial stunning. J Cardiol. 2007;49:106–7.
- Dhar S, Koul D, Subramanian S, Bakhshi M. Transient apical ballooning: sheep in wolves’ garb. Cardiol Rev. 2007;15(3):150–3. CrossRef
- Donohue D, Movahed MR. Clinical characteristics, demographics and prognosis of transient left ventricular apical ballooning syndrome. Heart Fail Rev. 2005;10:311–6. CrossRef
- Ennezat PV, Pesenti-Rossi D, Auber JM, Rachenne V, Bachart JJ, Auffray J, et al. Transient left ventricular basal dysfunction without coronary stenosis in acute cerebral disorders: a novel heart syndrome (inverted takotsubo). Echocardiography. 2005;22(7):599–602. CrossRef
- Gianni M, Dentali F, Grandi AM, Sumner G, Hiralai R, Lonn E. Apical ballooning syndrome or takotsubo cardiomyopathy: a systematic review. Eur Heart J. 2006;27:1523–9. CrossRef
- Haghi D, Fluechter S, Suselbeck T, Saur J, Bheleel O, Borggrefe M, et al. Takotsubo cardiomyopathy (acute left apical ballooning syndrome) occurring in the intensive care unit. Intensive Care Med. 2006;32:1069–74. CrossRef
- Ennezat PV, Pesenti-Rossi D, Aubert JM, Rachenne V, Bauchart JJ, Auffray JL, et al. Transient left ventricular basal dysfunction without coronary stenosis in acute cerebral disorders: a novel heart syndrome (inverted takotsubo). Echocardiography. 2005;22(7):599–602. CrossRef
- Kurowski V, Kasier A, vonHof K, Killermann DP, Mayer B, Hartmann F, et al. Apical and midventricular transient left ventricular dysfunction syndrome (Tako-tsubo cardiomyopathy): frequency, mechanisms, and prognosis. Chest. 2007;132:809–16. CrossRef
- Lee VH, Connolly HM, Fulgham JR, Manno EM, Brown RD Jr, Wijdicks EF. Tako-tsubo cardiomyopathy in aneurismal subarachnoid hemorrhage: an under appreciated ventricular dysfunction. J Neurosurg. 2006;105(2):264–70. CrossRef
- Metzl MD, Altman EJ, Spevack DM, Doddamani S, Travin MI, Ostfeld RJ. A case of takotsubo cardiomyopathy mimicking an acute coronary syndrome. Nat Clin Pract Cardiovasc Med. 2006;3(1):53–6. CrossRef
- Nef HM, Mollmann H, Elsasser A. Tako-tsubo cardiomyopathy (apical ballooning). Heart. 2007;93:1309–15. CrossRef
- Prasad A. Apical ballooning syndrome: An important differential diagnosis of acute myocardial infarction. Circulation. 2007;115:e56–9. CrossRef
- Purgason K. Broken hearts. Dimens Crit Care Nurs. 2006;25(6):247–53. CrossRef
- Seth PS, Aurigemma GP, Krasnow JM, Tighe DA, Untereker WJ, Meyer TE. A syndrome of transient left ventricular apical wall motion abnormality in the absence of coronary disease: a perspective from the United States. Cardiology. 2003;100:61–6. CrossRef
- Sharkey SW, Lesser JR, Zenovich AG, Maron MS, Lindberg J, Longe TF, et al. Acute and reversible cardiomyopathy provoked by stress in women from the United States. Circulation. 2005;111:472–9. CrossRef
- Wachsman DE, Davidoff R. Takotsubo cardiomyopathy: a little-known cardiomyopathy makes it US debut. Cardiology. 2004;102:119–21. CrossRef
- Weeks SG, Alvarez N, Pillay N, Bell RB. Tako tsubo cardiomyopathy secondary to seizures. Can J Neurol Sci. 2007;34(1):105–7.
- Wittstein IS, Thiemann MD, Lima JAC, Baughman KL, Schulman SP, Gerstenblith G, et al. Neurohumoral features of myocardial stunning due to sudden emotional stress. N Engl J Med. 2005;352(6):539–48. CrossRef
- Hessel EA. The brain and the heart. Cardiovasc Anesth. 2006;103(3):522–5.
- Tako-Tsubo Cardiomyopathy Associated with Seizures
Volume 9, Issue 1 , pp 112-117
- Cover Date
- Print ISSN
- Online ISSN
- Humana Press Inc
- Additional Links
- Neurogenic cardiomyopathy
- Takotsubo syndrome
- Neurological emergency
- Status epilepticus
- Reversible myocardial failure
- Industry Sectors
- Author Affiliations
- 1. Department of Neurology, Medical College of Wisconsin, Milwaukee, WI, USA
- 2. Department of Neurosurgery, Medical College of Wisconsin, Milwaukee, WI, USA
- 3. Neurointerventional Program, Medical College of Wisconsin, 9200 West Wisconsin Avenue, Milwaukee, WI, 53226, USA