Broken Heart Syndrome During Myasthenic Crisis

Abstract

SICM may occur in MG crisis, especially in the presence of malignant thymoma. All previous cases including our patient had improved myocardial function and clinical outcomes.

Defining Features of Patients who Develop Takotsubo Cardiomyopathy during Myasthenic Crisis: A Systematic Review of Case Studies

“…All studies were case reports published between 2005 and 2018. USA [8,9,10,12,18] and Asia [7,11,15,16,20] each conducted 5 studies, while 3 took place in Europe [13,14,19]. South America contributed to 1 study only [17].…”

“…5 articles did not mention any other complications [8,9,10,17,20]. Five articles emphasized a previous history of thymectomy [12] or thymoma [11,13,16,18]. The gradings for thymomas were B1 [16] or B2 [13,18].…”

“…Five articles emphasized a previous history of thymectomy [12] or thymoma [11,13,16,18]. The gradings for thymomas were B1 [16] or B2 [13,18]. 4 articles observed pulmonary edema as a complication during the myasthenic crisis [7,11,13,14], while 2 articles reported QT prolongation and Torsades de Pointes [15,19].…”

“…The average age for European studies was 73.7 years. 4 articles described male patients with an average age of 64.1 years [8,12,14,17], while the remaining 10 studies of female patients had an average age of 60.5 years [7,9,10,11,13,15,16,18,19,20]. Common medical history aside from myasthenia gravis and change in thyroid function included atrial fibrillation [13,15,19] and hypertension [9,13,14].…”

“…All studies reported respiratory distress, which encompassed breathlessness, shortness of breath, wheezing, respiratory failure, or respiratory muscle paralysis [7–20]. The next common presentation was generalized weakness and fatigue (71.4%) [7–11,14,16,17,19,20] followed by dysphagia (57.1%) [7 ,8,9,10,14,15,18,19] and then equally ocular problems involving either ptosis or diplopia [7,8,9,10,16,19] or dysarthria (42.9%) [7,8,9,13,14,19]. Chest pain was only reported in 21.4% of the cases [9,17,20].…”