Effectiveness of Levosimendan in an 84-Year-Old Patient with Takotsubo Syndrome Complicated by Acute Heart Failure

Zalewska-Adamiec, Małgorzata; Chlabicz, Małgorzata; Kuźma, Łukasz; Bachórzewska−Gajewska, Hanna; Dobrzycki, Sławomir

doi:10.12659/ajcr.927081

Cited by 5 publications

(5 citation statements)

References 12 publications

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“…In patients with signs of cardiogenic shock, mechanical support with temporary left ventricular assist devices and extracorporeal membrane oxygenation or levosimendan infusion can be considered [5]. Levosimendan is a non-catecholamine-positive inotrope that increases the calcium sensitivity of cardiomyocytes ultimately improving myocardial contractility in the setting of heart failure [13]. An ECHO is recommended before discharge from the hospital to determine the latest ejection fraction.…”

Section: Discussionmentioning

confidence: 99%

Peripheral Thromboembolism Formation in a Case of Takotsubo Cardiomyopathy

Patel¹,

Webeler²,

Gudur³

2022

Cureus

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Takotsubo cardiomyopathy (TC) is a reversible cardiac disorder of the elderly commonly seen in postmenopausal women. TC can present similar to acute coronary syndrome with chest pain and dyspnea; however, there is no coronary artery occlusion. Patients with TC classically show ventricular apical ballooning and hypokinesis on echocardiogram. Few cases of thromboembolism of the lower extremity due to Takotsubo have been reported in the literature. Here, we report a unique occurrence of a thromboembolism formation in the right common iliac and external iliac arteries in the context of TC. Through the mechanisms of TC that involve ventricular wall abnormalities, hypercoagulability, and catecholamine excess, thromboembolism in the iliac system was likely from the akinetic ventricle. In this case, computed tomography angiography was an essential diagnostic tool that revealed the peripheral occlusion; therefore, it should be considered in patients with a history of TC who complain of lower extremity pain and neurological symptoms.

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Section: Discussionmentioning

confidence: 99%

Peripheral Thromboembolism Formation in a Case of Takotsubo Cardiomyopathy

Patel¹,

Webeler²,

Gudur³

2022

Cureus

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“…67,165,166 Use of levosimendan has been suggested to expedite LV function recovery, but there are no data on its effect on arrhythmias or SCD. 167,168…”

Section: Treatment and Prophylaxismentioning

confidence: 99%

“…67,165,166 Use of levosimendan has been suggested to expedite LV function recovery, but there are no data on its effect on arrhythmias or SCD. 167,168 In cases of asystolic cardiac arrest, temporary pacing is instituted. As mentioned, any bradyarrhythmia, including complete AV block, may facilitate or trigger the occurrence of TdP through the mechanism of long-short sequence.…”

Section: Treatment and Prophylaxismentioning

confidence: 99%

Takotsubo Syndrome and Sudden Cardiac Death

Manolis

Manolis²,

Melita

et al. 2022

Angiology

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Takotsubo syndrome (TTS), triggered by intense emotional or physical stress, occurring most commonly in post-menopausal women, presents as an ST-elevation myocardial infarction (MI). Cardiovascular complications occur in almost half the patients with TTS, and the inpatient mortality is comparable to MI (4–5%) owing to cardiogenic shock, myocardial rupture, or life-threatening arrhythmias. Thus, its prognosis is not as benign as previously thought, as it may cause mechanical complications (cardiac rupture) and potentially lethal arrhythmias and sudden cardiac death (SCD). Similar to MI, some patients may perish before reaching the hospital due to out-of-hospital cardiac arrest; this may lead to underestimation of the actual SCD risk. Furthermore, after discharge, some patients may develop late SCD and/or TTS recurrence that may result in SCD. There are risk factors for SCD in TTS patients, such as severe/persistent QT-interval prolongation inciting torsade-de-pointes, other ECG abnormalities (diffuse giant negative T-waves, widened QRS-complex), bradyarrhythmias, comorbidities, concurrent obstructive coronary artery disease or vasospasm, male gender, older age, severe left ventricular dysfunction, and use of sympathomimetic drugs. All these issues are herein reviewed, case reports/series and data from large cohort studies and meta-analyses are analyzed, risk factors are tabulated, and proarrhythmic effects and management strategies are discussed and pictorially illustrated.

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“…The clinical symptoms, ischemic changes on the electrocardiogram, and increased concentration of cardiac enzymes are similar to those of myocardial infarction; however, cardiac catheterization does not demonstrate a significant coronary stenosis. A long-term prognosis is relatively good for TS, but in the acute phase of the disease, severe complications, such as cardiogenic shock, sudden cardiac arrest, or cardiac rupture, may occur [ 1 – 3 ].…”

Section: Introductionmentioning

confidence: 99%

Primary Takotsubo Syndrome as a Complication of Bladder Cancer Treatment in a 62-Year-Old Woman

et al. 2021

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Patient: Female, 62-year-old Final Diagnosis: Takotsubo syndrome Symptoms: Chest pain Medication: — Clinical Procedure: Coronarography Specialty: Cardiology • Oncology Objective: Unknown ethiology Background: The main causes for takotsubo syndrome (TS) in oncological patients are stress related to cancer diagnosis and treatment, pain in the course of the disease, treatment complications, and paraneoplastic syndromes. Case Report: An obese 62-year-old female patient, with a 3-day history of chest pain, was admitted to the hospital with a suspected acute coronary event. She had been diagnosed with high-grade bladder cancer 6 months before. After the transurethral electroresection of the tumor 5 months before and subsequent chemotherapy (gemcitabine and cisplatin), the patient was qualified for the next cancer surgery. On admission, the patient remained without chest pain. The ECG record demonstrated inverted T waves in the leads from above the anterior and lateral wall. The coronarography demonstrated minor atherosclerotic changes in the coronary arteries. The left ventriculography presented akinesis of the apex and the apical and mid-segment of the anterior wall, and the ejection fraction (EF) was 38%. Takotsubo syndrome was diagnosed. Laboratory testing revealed elevated concentration of troponin and N-terminal pro-B-type natriuretic peptide. The subsequent ECG records demonstrated deeply inverted T waves and numerous ventricular premature beats and increased QTc (528 ms). A control echocardiography showed improved left ventricular contractive function (EF – 47%). On the 4 th day of hospitalization, the patient was discharged and referred for further oncological treatment. Conclusions: The diagnosis of TS in oncology patients is difficult, especially in the presence of atherosclerotic lesions in coronary arteries. Takotsubo syndrome in cancer patients delays the next stages of oncological treatment, which worsens the prognosis of these patients.

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Effectiveness of Levosimendan in an 84-Year-Old Patient with Takotsubo Syndrome Complicated by Acute Heart Failure

Cited by 5 publications

References 12 publications

Peripheral Thromboembolism Formation in a Case of Takotsubo Cardiomyopathy

Peripheral Thromboembolism Formation in a Case of Takotsubo Cardiomyopathy

Takotsubo Syndrome and Sudden Cardiac Death

Primary Takotsubo Syndrome as a Complication of Bladder Cancer Treatment in a 62-Year-Old Woman

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