Takotsubo Cardiomyopathy Associated with Hyperthyroidism Treated with Thyroidectomy

Omar, Sabry; Ali, Emad; Mazek, Haitham; Mahmood, Tashfeen; Soontrapa, Suthipong; Suárez, José

doi:10.1080/08998280.2015.11929227

Cited by 9 publications

(4 citation statements)

References 7 publications

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“…Methimazole can unmask an underlying neuromuscular junction disorder in patient with Grave's disease or trigger myasthenia crisis in patients with coexisting myasthenia gravis [ 18 ]. Both Grave's disease and myasthenia crisis were independently known to cause Takotsubo cardiomyopathy [ 19 , 20 ]. In our patient, the combination of hyperthyroidism and methimazole might have triggered myasthenia crisis and subsequently SC.…”

Section: Discussionmentioning

confidence: 99%

“…In our patient, the combination of hyperthyroidism and methimazole might have triggered myasthenia crisis and subsequently SC. Over a dozen case reports describe Takotsubo cardiomyopathy complicating hyperthyroidism [ 19 ]. Coexisting coronary artery disease could cause chronic LV dysfunction with remodeling/thinning or new wall motion changes with ischemia.…”

Section: Discussionmentioning

confidence: 99%

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A Case Report of Recurrent Takotsubo Cardiomyopathy in a Patient during Myasthenia Crisis

Battineni

Mullaguri

Thanki

et al. 2017

Case Reports in Critical Care

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Introduction Patients with myasthenia crisis can develop Takotsubo stress cardiomyopathy (SC) due to emotional or physical stress and high level of circulating catecholamines. We report a patient who developed recurrent Takotsubo cardiomyopathy during myasthenia crisis. Coexisting autoimmune disorders known to precipitate stress cardiomyopathy like Grave's disease need to be evaluated. Case Report A 69-year-old female with seropositive myasthenia gravis (MG), Grave's disease, and coronary artery disease on monthly infusion of intravenous immunoglobulin (IVIG), prednisone, pyridostigmine, and methimazole presented with shortness of breath and chest pain. Electrocardiogram (ECG) showed ST elevation in anterolateral leads with troponemia. Coronary angiogram was unremarkable for occlusive coronary disease with left ventriculogram showing reduced wall motion with apical and mid left ventricle (LV) hypokinesis suggestive of Takotsubo stress cardiomyopathy. Her symptoms were attributed to MG crisis. Her symptoms, ECG, and echocardiographic findings resolved after five cycles of plasma exchange (PLEX). She had another similar episode one year later during myasthenia crisis with subsequent resolution in 10 days after PLEX. Conclusion Takotsubo cardiomyopathy can be one of the manifestations of myasthenia crisis with or without coexisting Grave's disease. These patients might benefit from meticulous fluid status and cardiac monitoring while administering rescue treatments like IVIG and PLEX.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

A Case Report of Recurrent Takotsubo Cardiomyopathy in a Patient during Myasthenia Crisis

Battineni

Mullaguri

Thanki

et al. 2017

Case Reports in Critical Care

View full text Add to dashboard Cite

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“…Takotsubo cardiomyopathy is characterized by transient left ventricular dysfunction with chest symptoms, elevated cardiac enzymes, and ECG changes such as ST segment elevation and/or T-wave inversion without coronary artery occlusion [ 11 ]. The association of Takotsubo syndrome and hyperthyroidism has been reported before [ 12 – 14 ]. Therefore Takotsubo cardiomyopathy may be considered in our patient.…”

Section: Discussionmentioning

confidence: 92%

Severe Hyperthyroidism Presenting with Acute ST Segment Elevation Myocardial Infarction

Zhou

Wang

et al. 2015

Case Reports in Cardiology

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Introduction. Acute myocardial infarction is life-threatening. A cardiac troponin rise accompanied by typical symptoms, ST elevation or depression is diagnostic of acute myocardial infarction. Here, we report an unusual case of a female who was admitted with chest pain. However, she did not present with a typical profile of an acute myocardial infarction patient. Case Presentation. A 66-year-old Han nationality female presented with chest pain. The electrocardiogram (ECG) revealed arched ST segment elevations and troponin was elevated. However, the coronary angiography showed a normal coronary arterial system. Thyroid function tests showed that this patient had severe hyperthyroidism. Conclusion. Our case highlights the possibility that hyperthyroidism may cause a large area of myocardium injury and ECG ST segment elevation. We suggest routine thyroid function testing in patients with chest pain.

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“…The catecholamine's action potentiating effect of thyroid hormone is suggested by the studies showing upregulation of beta-adrenergic receptors in the myocardium despite normal circulating levels of catecholamines. 7 Other hypotheses consider vasospastic angina and an imbalance of sympathetic and vagal system modulation. There are few case reports of TCMP associated with Grave's disease, toxic multinodular goiter, following thyroidectomy, and radioactive iodine treatment.…”

Section: Discussionmentioning

confidence: 99%

A Rare Case Report of Takotsubo Cardiomyopathy in a Patient with Hashimoto’s Encephalopathy and Autoimmune Thyroiditis

Kumar,

Gupta

2024

Indian Journal of Clinical Cardiology

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Takotsubo cardiomyopathy (TCMP), also called as stress cardiomyopathy, is a transient left ventricular (LV) dysfunction. TCMP’s association with endocrine and thyroid diseases has been recently described, but TCMP in a patient of Hashimoto’s thyroiditis with encephalopathy is rarely reported. 1 Here, we present a recent case of TCMP in a patient with Hashimoto’s encephalopathy who was treated with steroids and responded well. Our case here highlights about having a lower threshold for screening of thyroid and other endocrine disorders in patients with TCMP.

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Takotsubo Cardiomyopathy Associated with Hyperthyroidism Treated with Thyroidectomy

Cited by 9 publications

References 7 publications

A Case Report of Recurrent Takotsubo Cardiomyopathy in a Patient during Myasthenia Crisis

A Case Report of Recurrent Takotsubo Cardiomyopathy in a Patient during Myasthenia Crisis

Severe Hyperthyroidism Presenting with Acute ST Segment Elevation Myocardial Infarction

A Rare Case Report of Takotsubo Cardiomyopathy in a Patient with Hashimoto’s Encephalopathy and Autoimmune Thyroiditis

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