Pericarditis in Takotsubo Cardiomyopathy: A Case Report and Review of the Literature

Abstract

Case. A 64-year-old Caucasian woman was brought to the emergency department with severe dysphagia and left chest pain for last 4 days. Initial evaluation revealed elevated ST segment in precordial leads on EKG with elevated cardiac enzymes. Limited echocardiogram showed infra-apical wall hypokinesia. Cardiac angiography was done subsequently which showed nonflow limiting mild coronary artery disease. Takotsubo cardiomyopathy was diagnosed and she was treated medically. On the third day of admission, a repeat ECG showed diffuse convex ST-segment elevations in precordial leads, compatible with acute pericarditis pattern of EKG. Decision was made to start colchicine empirically for possible pericarditis. Follow-up EKG in 2 days showed decreased ST-segment elevations in precordial leads. The patient was discharged with colchicine and a follow-up echocardiogram in 4 weeks demonstrated a normal ejection fraction with no evidence of pericarditis. Conclusion. Acute pericarditis can be associated either as a consequence of or as a triggering factor for Takotsubo cardiomyopathy. It is vital for physicians to be aware of pericarditis as a potential complication of Takotsubo cardiomyopathy.

Acute Hypotension and Chest Pain as the Presentation of a Post-Myocardial Infarction Acute Pericarditis (Dressler’s Syndrome)

“…DS is part of the so-called post cardiac injury syndrome (PCIS), an inflammatory process that occurs in the setting of injury to the pericardium, epicardium or myocardium, following cardiac surgery, myocardial infarction, trauma, intra-cardiac ablation, percutaneous coronary intervention or implantation of a pacemaker or cardioverter-defibrillator. Moreover, DS can represent either a triggering factor of or a consequence of Takotsubo cardiomyopathy [10]. Even if male gender was more represented in our series, the risk of developing pericarditis is similar in men and women, also because women are more likely to present autoimmune diseases [11].…”

PR deviation as a risk marker for cardiac events in patients with Takotsubo syndrome

“…The authors reported a case in which an 84‐year‐old woman was diagnosed as having TTS with acute pericarditis as revealed on ECG. Currently, numerous studies demonstrate the coexistence of acute pericarditis and TTS . In these studies, several cases of PR deviation can be found.…”

Tacotsubo Syndrome in the Course of Internal Diseases

“…У некоторых больных с СТ в фазе восстановле-ния может развиться острый перикардит с возобнов-лением болей в грудной клетке, а также повторным подъемом сегмента ST от изоэлектрической линии и определением небольшого выпота в полости пе-рикарда [34] примерно у 43% больных.…”

“…Вовлечение правого желудочка [18][19][20][21][22][23][24][25][26][27][28][29][30][31][32][33][34] Острая сердечная недостаточность Обструкция выносящего тракта левого желудочка [10][11][12][13][14][15][16][17][18][19][20][21][22][23][24][25] Митральная регургитация [14][15][16][17][18][19][20][21][22][23][24][25] Кардиогенный шок [6][7][8][9][10][11][12][13][14][15][16][17][18][19][20] Аритмии Фибрилляция предсердий [5][6]…”

“…В частности, длительное курение повышает риск развития туберкулеза в 15 раз по сравнению с некурящими. ХОБЛ выявляется у [23][24][25][26][27][28][29][30][31][32][33][34][35],5% пациентов с впервые выявленным туберкулезом, у каждого пятого диагностируется крайне тяжелая стадия заболевания по критериям GOLD. При сочетании ХОБЛ и туберкулеза наблюдается синдром взаимного отягощения: туберкулез характеризуется более выраженной клинической симптоматикой, чаще формируются полости распада с массивным бактериовыделением, чаще развивается хроническая дыхательная, сердечная недостаточность, отмечается неблагоприятный исход туберкулеза и более тяжелое течение ХОБЛ.…”