Takotsubo Cardiomyopathy: A New Perspective in Asthma

Marmoush, Fady; Barbour, Mohamad Firas; Noonan, Thomas; Al-Qadi, Mazen O.

doi:10.1155/2015/640795

Cited by 10 publications

(3 citation statements)

References 22 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Other studies have also shown stress cardiomyopathy in the setting of an acute asthma exacerbation or after repeated use of beta2-agonist inhalation [10][11][12][13][14][15][16][17]. Most of the cases involved elderly women with a history of asthma presenting with dyspnea rather than chest pain [12][13][14][15][16][17][18][19]. Only 1 case involved a male patient who presented with asthma exacerbation complicated with stress cardiomyopathy after frequent inhalation of steroids and long acting beta2-agonist [17].…”

Section: Discussionmentioning

confidence: 99%

Rare Association of Takotsubo Cardiomyopathy with Right Bundle Branch Block in the Dual Setting of Asthma Exacerbation and Psychiatric Illness

et al. 2020

View full text Add to dashboard Cite

Rare co-existance of disease or pathology Background: Takotsubo cardiomyopathy is characterized by a transient left ventricular dysfunction without obstructive coronary artery disease that mimics an acute myocardial infarction. The electrocardiogram findings of Takotsubo cardiomyopathy usually present with ST-segment elevation or depression, T-wave inversion, left bundle branch block or high-grade atrioventricular block. Case Report: This is a report of a case of a 58-year-old male diagnosed with Takotsubo cardiomyopathy that occurred in the setting of an acute asthma exacerbation and psychiatric exacerbation with novel electrocardiogram findings of right bundle branch block. Transthoracic echocardiogram showed a preserved ejection fraction with left ventricular apical ballooning and hyperkinesis of the basal segments. The nuclear stress test showed a fixed perfusion defect at the apical segment, but the patient refused further testing such as coronary angiography. The patient was managed medically, and a repeat echocardiogram done after 8 weeks from discharge showed a complete resolution of the apical ballooning. Conclusions: It is important to recognize that patients with psychiatric illness and asthma exacerbation are predisposed to develop Takotsubo cardiomyopathy. It is also reasonable to suspect Takotsubo cardiomyopathy in the presence of new electrocardiogram findings aside from those typically seen in acute myocardial infarction, especially if it is associated with apical ballooning.

show abstract

Section: Discussionmentioning

confidence: 99%

Rare Association of Takotsubo Cardiomyopathy with Right Bundle Branch Block in the Dual Setting of Asthma Exacerbation and Psychiatric Illness

et al. 2020

View full text Add to dashboard Cite

show abstract

“…Parodi et al reported an estimated prevalence of LBBB in 9% of TTC patients at the time of diagnosis [28]. Other isolated case reports establishing an association between TTC and new or old LBBB have also been reported in the literature [29–31]. The presence of conduction abnormalities in TTC can be attributed to decreased blood flow to the ventricular conduction system either due to left ventricular dyskinesia or catecholamine-induced vasospasm [30].…”

Section: Discussionmentioning

confidence: 99%

Implications of Left Bundle Branch Block in Takotsubo Cardiomyopathy: Propensity Match Analysis from the National Inpatient Sample

et al. 2019

View full text Add to dashboard Cite

IntroductionTakotsubo cardiomyopathy (TTC), also called stress cardiomyopathy, is a transient reversible left ventricular dysfunction mimicking acute coronary syndrome (ACS). Studies have shown similar rates of in-hospital complications in TTC and myocardial infarction (MI). Left bundle branch block (LBBB) is associated with increased mortality in patients with MI; however, similar studies comparing outcomes of TTC in the presence of LBBB are lacking.MethodsThe 2016 National Inpatient Sample (NIS) database was queried to identify all admissions with a primary discharge diagnosis of TTC. Diagnosis-specific codes were used to stratify patients based on the presence or absence of LBBB. Both population sets were paired using 1:10 propensity score matching. Multivariate logistic regression analysis was performed to compare various in-hospital outcomes among both groups.ResultsAmongst 7270 admissions for TTC, 226 patients had concomitant LBBB. After performing 1:10 propensity matching, 130 patients with LBBB were compared to 1275 patients without LBBB. The presence of LBBB was associated with increased odds of cardiogenic shock (AOR = 2.2, 95% CI 1.21–3.99, p = 0.0097); ventricular arrhythmia (AOR 1.99, 95% CI 1.11–3.57, p = 0.02), acute congestive heart failure (AOR = 1.49, 95% CI 1.01–2.2, p = 0.04), and sudden cardiac arrest (AOR = 3.37, 95% CI 1.59–7.13, p = 0.0001). There was no statistical difference in all-cause in-hospital mortality, however a trend towards worsening was noted.ConclusionsThe incidence of arrhythmia and shock in patients with TTC does not correlate with the extent of myocardium involvement. The presence of LBBB in such cases can help recognize at-risk populations, and with timely intervention, life-threatening complications can be avoided. Despite limitations of the dataset and inability to establish causality, prospective studies with longer follow-up are warranted.

show abstract

“…I read with interest the study by Marmoush et al [ 1 ] about the 80-year-old woman with an exacerbation of her asthma who suffered Takotsubo syndrome (TTS), after using “her rescue albuterol inhaler several times.” As the authors state this is not the first case of an albuterol-triggered TTS, as shown by many similar cases of TTS published as single case reports and series of patients derived from cohorts admitted to the respiratory intensive care unit, treated with a variety of β 2 -adrenergic agents. I have some thoughts for the authors to consider.…”

Takotsubo Cardiomyopathy: A New Perspective in Asthma

Cited by 10 publications

References 22 publications

Rare Association of Takotsubo Cardiomyopathy with Right Bundle Branch Block in the Dual Setting of Asthma Exacerbation and Psychiatric Illness

Rare Association of Takotsubo Cardiomyopathy with Right Bundle Branch Block in the Dual Setting of Asthma Exacerbation and Psychiatric Illness

Implications of Left Bundle Branch Block in Takotsubo Cardiomyopathy: Propensity Match Analysis from the National Inpatient Sample

Comment on “Takotsubo Cardiomyopathy: A New Perspective in Asthma”

Contact Info

Product

Resources

About