Takotsubo Cardiomyopathy and Subsequent Seizures Induced by Flexible Bronchoscopy

Abstract

Takotsubo cardiomyopathy is a transient left-ventricular dysfunction that typically occurs in elderly women due to emotional or physical stress. An 85-y-old woman underwent flexible bronchoscopy to evaluate her malignant lymphoma. After flexible bronchoscopy, she experienced takotsubo cardiomyopathy diagnosed by left ventriculography and subsequent generalized tonic-clonic seizure diagnosed by electroencephalography. Magnetic resonance imaging of her brain after 1 d showed post-convulsive encephalopathy. We believe that these 2 consecutive incidents were caused by the physical stress of the flexible bronchoscopy.

Takotsubo Syndrome Secondary to Pulmonary Bronchoscopy

“…In the reported case, the development of TS was preceded by bronchoscopy, a normally safe procedure that is a diagnostic and therapeutic pillar of pulmonary medicine. Complications of bronchoscopy are uncommon and usually occur in older patients with coexisting coronary artery disease, hypertension or compromised pulmonary function, with most of these events being hypoxaemia, arrythmias, bleeding, pneumothorax and pneumomediastinum [9,10] . A typical case of TS is characterized by anginous precordial pain and electrophysiological anomalies, such as ST segment elevation or T wave inversion, which facilitates underdiagnosis due to low clinical suspicion [3,4].…”

“…In the reported case, the development of TS was preceded by bronchoscopy, a normally safe procedure that is a diagnostic and therapeutic pillar of pulmonary medicine. Complications of bronchoscopy are uncommon and usually occur in older patients with coexisting coronary artery disease, hypertension or compromised pulmonary function, with most of these events being hypoxaemia, arrythmias, bleeding, pneumothorax and pneumomediastinum [ 9 , 10 ] .…”

Diagnosis and prognosis of myocardial infarction in a patient without obstructive coronary artery disease during bronchoscopy: a case study and literature review

“…There are a few reports of takotsubo cardiomyopathy induced by flexible bronchoscopy which may be attributed to over-released catecholamines due to the extreme stress [9][10][11][12]. The manifestation of Takotsubo syndrome could be similar to AMI, and it is characterized by transient left ventricular dysfunction and ballooning of the apical part of the left ventricular with reduced LVEF [13,14].…”