Reverse Apical Ballooning Echocardiographic Pattern in Eclampsia-Related Cardiomyopathy

Gleich, Stephen J.; Barbara, David W.; Arendt, Katherine W.; Rose, Carl H.; Blauwet, Lori A.

doi:10.1213/xaa.0000000000000205

Cited by 3 publications

(5 citation statements)

References 17 publications

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“…Only six patients have been reported including the present patient: TTS occurred in the first to second trimester in four patients and in the third trimester in two patients (Table 1). [4][5][6][7][8] In the present patient, TTS occurred concomitantly with PE, leading to a poor neonatal outcome. Although previous reports on pregnancy-associated TTS showed a good maternal outcome, antenatally occurring TTS complicated by severe PE may become critical for fetuses.…”

Section: Discussionmentioning

confidence: 59%

Section: Discussionmentioning

confidence: 62%

“…It is noteworthy that of the six patients involving antenatally occurring TTS, three (50%) suffered severe PE, with all requiring CS (Table 1). [4][5][6][7][8] The other two patients except a case with abortion showed mild symptoms and did not require emergent delivery. This close association between PE and antenatally occurring TTS suggests that their concomitant occurrence may not be a coincidence.…”

Section: Discussionmentioning

confidence: 93%

“…It is noteworthy that of the six patients involving antenatally occurring TTS, three (50%) suffered severe PE, with all requiring CS (Table ) . The other two patients except a case with abortion showed mild symptoms and did not require emergent delivery.…”

Section: Discussionmentioning

confidence: 97%

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Takotsubo syndrome occurring concomitantly with pre‐eclampsia: A case report

Horie

Takahashi

Fujimoto

et al. 2019

J of Obstet and Gynaecol

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Takotsubo syndrome (TTS) patients show transient ventricular dysfunction without coronary artery stenosis. We report a pregnant woman with TTS occurring concomitantly with severe pre‐eclampsia (PE). A primiparous woman complained of dyspnea at 35 weeks of gestation. She showed severe PE, and cardiac ultrasound identified akinesis of the anterior lower wall. On the same day, emergent cesarean section was performed due to a nonreassuring fetus status, yielding a male infant with an umbilical artery pH of 6.851. Unfortunately, the neonate died of multiple organ failure. Following the delivery, her cardiac function markedly improved, and coronary angiography showed no coronary artery stenosis. Considering the clinical findings, we diagnosed the patient with TTS. Regarding antenatally occurring TTS, only six patients have been reported including the present one. Of the six patients, three had severe PE. Although previous reports on pregnancy‐associated TTS described good maternal outcomes, antenatally occurring TTS complicated by severe PE may become critical for fetuses.

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Section: Discussionmentioning

confidence: 59%

Section: Discussionmentioning

confidence: 62%

Section: Discussionmentioning

confidence: 93%

Section: Discussionmentioning

confidence: 97%

See 2 more Smart Citations

Takotsubo syndrome occurring concomitantly with pre‐eclampsia: A case report

Horie

Takahashi

Fujimoto

et al. 2019

J of Obstet and Gynaecol

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“…Only few cases with this rare anatomical variant of TTS related to pregnancy have been described. [3][4][5][6][7][8]…”

Section: Introductionmentioning

confidence: 99%

Reverse Takotsubo Syndrome, a Case Report of a Rare Cause for Postpartum Heart Failure

Kilian¹,

Haaf²,

Pfister³

et al. 2018

Cardiogenetics

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Predominant causes for newly diagnosed postpartum heart failure are preeclampsia and peripartum cardiomyopathy. Being an anatomical variant of Takotsubo syndrome (TTS) reverse TTS in this period is rare. We present a 36 year old patient, who had delivered triplets by cesarean section. Because of postpartum bleeding she was administered sulprostone. Later she was transferred to the Intensive Care Unit with sudden development of dyspnea, tachypnea and tachycardia. Clinical symptoms, laboratory findings and chest radiograph showed signs of acute heart failure. Transthoracic echocardiography (TTE) revealed reverse TTS with moderately reduced left ventricular ejection fraction (LVEF 39%). The patient stabilized with loop diuretic, angiotensine-converting enzyme inhibitors and beta-blockade. Breast-feeding was discouraged and bromocriptine administered. Left ventricular function normalized (LVEF 60%) within four weeks. TTS should be considered in patients with early postpartum development of heart failure. Rapid cardiac recompensation after the start of adequate therapy and complete resolution of clinical symptoms and TTE findings are typical for postpartum TTS.

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Takotsubo Cardiomyopathy in Pregnancy: A Focused Review

Garg,

Singh,

Ramachandran

et al. 2023

Journal of Obstetric Anaesthesia and Critical Care

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Takotsubo cardiomyopathy (TTCM) has been described as a new entity of cardiomyopathy at the turn of the century. Takotsubo, a Japanese word, denotes an “octopus pot,” a fishing jar that has a narrow neck and wide base for trapping an octopus. This correlates with the shape of the heart on left ventriculography with apical ballooning and basal hypokinesia. The first case was defined in 1990 by Sato et al. and a plethora of literature exists about TTCM ever since. While believed to be an occurrence in elderly postmenopausal females, various reports have been found in recent literature highlighting its occurrence during the antenatal, perinatal, and postpartum periods. It is high time that TTCM is kept in the purview of diagnosing acute cardiopulmonary symptoms in pregnancy. Only an accurate and timely diagnosis of TTCM in pregnancy can lead to an early intervention and prevent countless morbidities and mortalities. A multidisciplinary approach with psychological rehabilitation is recommended to prevent recurrence. We present a concise review of the diagnosis, clinical features and management of this condition and the salient differentiating features from peripartum cardiomyopathy (PPCM). We found 26 cases of TTCM and 16 cases of reverse TTCM. There is a void in knowledge about estrogen levels and the corresponding levels of catecholamines in due course of pregnancy. Future studies to correlate between declining estrogen levels and catecholamine levels at the onset of symptoms of TTCM need to be done to get more insights into this phenomenon.

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Reverse Apical Ballooning Echocardiographic Pattern in Eclampsia-Related Cardiomyopathy

Cited by 3 publications

References 17 publications

Takotsubo syndrome occurring concomitantly with pre‐eclampsia: A case report

Takotsubo syndrome occurring concomitantly with pre‐eclampsia: A case report

Reverse Takotsubo Syndrome, a Case Report of a Rare Cause for Postpartum Heart Failure

Takotsubo Cardiomyopathy in Pregnancy: A Focused Review

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