Biventricular Takotsubo Syndrome Complicated with Cardiogenic Shock and Ventricular Septal Rupture: a Case Report

Overview

Journal Eur Heart J Case Rep

Publisher Oxford University Press

Specialty Cardiology & Vascular Diseases

Date 2024 Apr 8

PMID 38586534

Authors

Mariana Sousa Paiva

Sergio Maltes

Catarina Brizido

Marcio Madeira

Antonio Tralhao

Affiliations

Soon will be listed here.

Abstract

Background: Takotsubo syndrome (TTS) mimics acute coronary syndromes but can lead to serious cardiac complications, emphasizing the need for improved understanding and management.

Case Summary: We describe a TTS case presented with cardiogenic shock due to ventricular septal rupture (VSR). Successful treatment involved mechanical circulatory support followed by VSR surgical closure.

Discussion: Ventricular septal rupture is the rarest and deadliest complication associated with TTS. Prompt recognition and a multidisciplinary approach are crucial to achieve the best possible outcome.

Citing Articles

ST-segment elevation in V1-4 in takotsubo cardiomyopathy with ventricular septal perforation: A case report and literature review.

Haruki S, Yamamoto H, Isogai J Heliyon. 2024; 10(19):e38812.

PMID: 39444407 PMC: 11497400. DOI: 10.1016/j.heliyon.2024.e38812.

References

Sakai K, Ochiai H, Katayama N, Nakamura K, Arataki K, Kido T . Ventricular septal perforation in a patient with takotsubo cardiomyopathy. Circ J. 2005; 69(3):365-7. DOI: 10.1253/circj.69.365. View

Redfors B, Vedad R, Angeras O, Ramunddal T, Petursson P, Haraldsson I . Mortality in takotsubo syndrome is similar to mortality in myocardial infarction - A report from the SWEDEHEART registry. Int J Cardiol. 2015; 185:282-9. DOI: 10.1016/j.ijcard.2015.03.162. View

Ghadri J, Cammann V, Jurisic S, Seifert B, Napp L, Diekmann J . A novel clinical score (InterTAK Diagnostic Score) to differentiate takotsubo syndrome from acute coronary syndrome: results from the International Takotsubo Registry. Eur J Heart Fail. 2016; 19(8):1036-1042. DOI: 10.1002/ejhf.683. View

Templin C, Ghadri J, Diekmann J, Napp L, Bataiosu D, Jaguszewski M . Clinical Features and Outcomes of Takotsubo (Stress) Cardiomyopathy. N Engl J Med. 2015; 373(10):929-38. DOI: 10.1056/NEJMoa1406761. View

Pepe M, Paradies V, Bortone A, De Cillis E, Cafaro A, Acquaviva T . 'Broken-heart' syndrome: ventricular septal perforation in a takotsubo cardiomyopathy. Future Cardiol. 2016; 12(3):255-9. DOI: 10.2217/fca.16.4. View

Narita M, Sakakura K, Ohashi J, Ibe T, Yamamoto K, Wada H . Medically Treated Ventricular Septal Perforation Caused by Takotsubo Cardiomyopathy. Int Heart J. 2018; 60(1):215-219. DOI: 10.1536/ihj.18-066. View

Zhukova N, Merkulova I, Shakhnovich R, Merkulov E, Osiev A, Pevzner D . [Endovascular closure of a ventricular septal defect from Takotsubo Syndrome]. Ter Arkh. 2020; 91(9):115-123. DOI: 10.26442/00403660.2019.09.000363. View

Chioncel O, Parissis J, Mebazaa A, Thiele H, Desch S, Bauersachs J . Epidemiology, pathophysiology and contemporary management of cardiogenic shock - a position statement from the Heart Failure Association of the European Society of Cardiology. Eur J Heart Fail. 2020; 22(8):1315-1341. DOI: 10.1002/ejhf.1922. View

Papalexopoulou N, Young C, Attia R . What is the best timing of surgery in patients with post-infarct ventricular septal rupture?. Interact Cardiovasc Thorac Surg. 2012; 16(2):193-6. PMC: 3548527. DOI: 10.1093/icvts/ivs444. View

10.

Izumi K, Tada S, Yamada T . A case of Takotsubo cardiomyopathy complicated by ventricular septal perforation. Circ J. 2008; 72(9):1540-3. DOI: 10.1253/circj.cj-07-0907. View

11.

Kumar S, Kaushik S, Nautiyal A, Choudhary S, Kayastha B, Mostow N . Cardiac rupture in takotsubo cardiomyopathy: a systematic review. Clin Cardiol. 2011; 34(11):672-6. PMC: 6652409. DOI: 10.1002/clc.20957. View

12.

Ghadri J, Wittstein I, Prasad A, Sharkey S, Dote K, Akashi Y . International Expert Consensus Document on Takotsubo Syndrome (Part I): Clinical Characteristics, Diagnostic Criteria, and Pathophysiology. Eur Heart J. 2018; 39(22):2032-2046. PMC: 5991216. DOI: 10.1093/eurheartj/ehy076. View

13.

Zalewska-Adamiec M, Bachorzewska-Gajewska H, Dobrzycki S . Cardiac Rupture-The Most Serious Complication of Takotsubo Syndrome: A Series of Five Cases and a Systematic Review. J Clin Med. 2021; 10(5). PMC: 7962024. DOI: 10.3390/jcm10051066. View

14.

Prasad A, Dangas G, Srinivasan M, Yu J, Gersh B, Mehran R . Incidence and angiographic characteristics of patients with apical ballooning syndrome (takotsubo/stress cardiomyopathy) in the HORIZONS-AMI trial: an analysis from a multicenter, international study of ST-elevation myocardial infarction. Catheter Cardiovasc Interv. 2011; 83(3):343-8. DOI: 10.1002/ccd.23441. View

15.

Birnbaum Y, Chamoun A, Anzuini A, Lick S, Ahmad M, Uretsky B . Ventricular free wall rupture following acute myocardial infarction. Coron Artery Dis. 2003; 14(6):463-70. DOI: 10.1097/00019501-200309000-00008. View

16.

Sacha J, Maselko J, Wester A, Szudrowicz Z, Pluta W . Left ventricular apical rupture caused by takotsubo cardiomyopathy--comprehensive pathological heart investigation. Circ J. 2007; 71(6):982-5. DOI: 10.1253/circj.71.982. View