Reversible Stress Cardiomyopathy in Guillain-Barré Syndrome: a Case Report

Overview

Journal J Med Case Rep

Publisher Biomed Central

Specialty General Medicine

Date 2019 May 21

PMID 31104633

Citations 7

Authors

A Gravos

A Destounis

K Katsifa

P Tselioti

K Sakellaridis

V Grammatikopoulou

C Tsapas

A Nodarou

P Batiani

A Prekates

Affiliations

Soon will be listed here.

Abstract

Background: Guillain-Barré syndrome is an autoimmune disorder in which autoantibodies mainly affect the peripheral nervous system. Autonomic dysfunction is a common and severe complication of Guillain-Barré syndrome. Cardiomyopathy, though, is a rare complication in Guillain-Barré syndrome, with only a few cases reported in the literature.

Case Presentation: We present a case of a 65-year-old Greek woman with Guillain-Barré syndrome who developed cardiomyopathy shortly after admission to the intensive care unit due to respiratory deterioration. Her estimated left ventricular ejection fraction upon admission was 20%. The result of coronary angiography was negative for coronary artery disease, and cardiac magnetic resonance imaging excluded myocarditis. Her clinical condition improved with supportive therapy, and her estimated left ventricular ejection fraction at discharge was normal.

Conclusions: Clinicians should be aware of this potentially lethal complication of Guillain-Barré syndrome and the therapeutic options, because early diagnosis can improve prognosis. Routine electrocardiographic and echocardiographic assessments should be performed in patients with Guillain-Barré syndrome presenting with hemodynamic instability.

Citing Articles

Takotsubo Cardiomyopathy and Autoimmune Disorders: A Systematic Scoping Review of Published Cases.

Kouhanjani M, Hosseini S, Mousavi S, Noroozi Z, Sadeghi P, Jokar-Derisi A Int J Clin Pract. 2024; 2024:7259200.

PMID: 38414580 PMC: 10898954. DOI: 10.1155/2024/7259200.

Takotsubo Cardiomyopathy: A Possible Rare Complication of Guillain-Barré Syndrome.

Mohamed K, Oshikoya A, Kumar K, Anigbo C, Prashanth P, Mohamed A Cureus. 2023; 15(6):e40083.

PMID: 37425556 PMC: 10327529. DOI: 10.7759/cureus.40083.

Acute neurogenic stunned myocardium in a patient with Guillain-Barré syndrome: case report.

Bahouh C, Arhoun El Haddad I, Elmouhib A, Laaribi I, El Adak H, Hattab O Ann Med Surg (Lond). 2023; 85(5):2186-2189.

PMID: 37229079 PMC: 10205362. DOI: 10.1097/MS9.0000000000000636.

Isolated right ventricular Takotsubo cardiomyopathy in Guillain-Barré syndrome.

Song X, Chi C, Song J, Zhu J BMC Cardiovasc Disord. 2022; 22(1):531.

PMID: 36476210 PMC: 9727852. DOI: 10.1186/s12872-022-02983-1.

A Severe Pharyngeal-Sensory-Ataxic Variant of Guillain-Barré Syndrome With Transient Cardiac Dysfunction and a Positive Anti-sulfatide IgM.

Lee K, Abdul Halim S, Sapiai N Cureus. 2022; 14(9):e29261.

PMID: 36277590 PMC: 9578660. DOI: 10.7759/cureus.29261.

References

Bernstein R, Mayer S, Magnano A . Neurogenic stunned myocardium in Guillain-Barré syndrome. Neurology. 2000; 54(3):759-62. DOI: 10.1212/wnl.54.3.759. View

Oomura M, Yamawaki T, Oe H, Moriwaki H, Miyashita K, Naritomi H . Association of cardiomyopathy caused by autonomic nervous system impairment with the Miller Fisher syndrome. J Neurol Neurosurg Psychiatry. 2003; 74(5):689-90. PMC: 1738425. DOI: 10.1136/jnnp.74.5.689. View

Ropper A . The Guillain-Barré syndrome. N Engl J Med. 1992; 326(17):1130-6. DOI: 10.1056/NEJM199204233261706. View

Naidech A, Du Y, Kreiter K, Parra A, Fitzsimmons B, Lavine S . Dobutamine versus milrinone after subarachnoid hemorrhage. Neurosurgery. 2004; 56(1):21-6l discussion 26-7. DOI: 10.1227/01.neu.0000144780.97392.d7. View

Finkelstein J, Melek B . Guillain-Barré syndrome as a cause of reversible cardiomyopathy. Tex Heart Inst J. 2006; 33(1):57-9. PMC: 1413614. View

Palazzuoli A, Lenzi C, Iovine F, Carrera A, Nuti R . A case of acute heart failure associated with Guillain-Barré syndrome. Neurol Sci. 2006; 26(6):447-50. DOI: 10.1007/s10072-006-0531-0. View

Flachenecker P . Autonomic dysfunction in Guillain-Barré syndrome and multiple sclerosis. J Neurol. 2007; 254 Suppl 2:II96-101. DOI: 10.1007/s00415-007-2024-3. View

Elliott P, Andersson B, Arbustini E, Bilinska Z, Cecchi F, Charron P . Classification of the cardiomyopathies: a position statement from the European Society Of Cardiology Working Group on Myocardial and Pericardial Diseases. Eur Heart J. 2007; 29(2):270-6. DOI: 10.1093/eurheartj/ehm342. View

Lyon A, Rees P, Prasad S, Poole-Wilson P, Harding S . Stress (Takotsubo) cardiomyopathy--a novel pathophysiological hypothesis to explain catecholamine-induced acute myocardial stunning. Nat Clin Pract Cardiovasc Med. 2007; 5(1):22-9. DOI: 10.1038/ncpcardio1066. View

10.

Seifert T, Klein E, Legat-Wallner S, Krenn U, Brussee H, Lueger A . Bilateral vertebral artery dissection and infratentorial stroke complicated by stress-induced cardiomyopathy. J Neurol Neurosurg Psychiatry. 2008; 79(4):480-1. DOI: 10.1136/jnnp.2007.133975. View

11.

Mukerji S, Aloka F, Farooq M, Kassab M, Abela G . Cardiovascular complications of the Guillain-Barré syndrome. Am J Cardiol. 2009; 104(10):1452-5. DOI: 10.1016/j.amjcard.2009.06.069. View

12.

Martins R, Barbarot N, Coquerel N, Baruteau A, Kolev I, Verin M . Takotsubo cardiomyopathy associated with Guillain-Barré syndrome: a differential diagnosis from dysautonomia not to be missed. J Neurol Sci. 2010; 291(1-2):100-2. DOI: 10.1016/j.jns.2010.01.005. View

13.

Lazaridis C, Pradilla G, Nyquist P, Tamargo R . Intra-aortic balloon pump counterpulsation in the setting of subarachnoid hemorrhage, cerebral vasospasm, and neurogenic stress cardiomyopathy. Case report and review of the literature. Neurocrit Care. 2010; 13(1):101-8. DOI: 10.1007/s12028-010-9358-x. View

14.

Busani S, Rinaldi L, Severino C, Cobelli M, Pasetto A, Girardis M . Levosimendan in cardiac failure after subarachnoid hemorrhage. J Trauma. 2010; 68(5):E108-10. DOI: 10.1097/TA.0b013e31817c4284. View

15.

Rousseff R, Al-Khashan S, Khuraibet A . Transient cardiomyopathy as the presenting feature of Guillain-Barré syndrome. J Peripher Nerv Syst. 2010; 15(2):153-5. DOI: 10.1111/j.1529-8027.2010.00265.x. View

16.

Ibrahim K, Jellinghaus S, Christoph M, Pfluecke C, Guenther M, Ney M . Intracranial hemorrhage causes a transmural myocardial infarction without the presence of coronary atherosclerosis. Int J Cardiol. 2010; 152(2):e40-1. DOI: 10.1016/j.ijcard.2010.10.077. View

17.

Havel C, Arrich J, Losert H, Gamper G, Mullner M, Herkner H . Vasopressors for hypotensive shock. Cochrane Database Syst Rev. 2011; (5):CD003709. DOI: 10.1002/14651858.CD003709.pub3. View

18.

Guglin M, Novotorova I . Neurogenic stunned myocardium and takotsubo cardiomyopathy are the same syndrome: a pooled analysis. Congest Heart Fail. 2011; 17(3):127-32. DOI: 10.1111/j.1751-7133.2011.00210.x. View

19.

Quick S, Quick C, Schneider R, Sveric K, Katzke S, Strasser R . Guillain-Barré syndrome and catecholamine therapy. A potential risk for developing takotsubo cardiomyopathy?. Int J Cardiol. 2012; 165(3):e43-4. DOI: 10.1016/j.ijcard.2012.10.083. View

20.

Szardien S, Mollmann H, Willmer M, Akashi Y, Hamm C, Nef H . Mechanisms of stress (takotsubo) cardiomyopathy. Heart Fail Clin. 2013; 9(2):197-205, ix. DOI: 10.1016/j.hfc.2012.12.012. View