Takotsubo cardiomyopathy: a rare, but serious, complication of epileptic seizures

Rocha, João Carlos da; Gonçalves, Elsa; Vieira, Catarina; Almeida, F.; Pereira, João

doi:10.1590/s0004-282x2013000300014

Cited by 14 publications

(12 citation statements)

References 4 publications

(4 reference statements)

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“…In 23 cases, TTS was reported to develop immediately after the seizure and signs of TTS were already present at hospital admission (Table 1) [4][5][6]8,9,13,14,16,[20][21][22][23][24][25][26][27][28][29][30][31][32][33][34]. In the remaining 25 cases, detection of TTS was reported 5-288 (mean 50) hours after the seizure (Table 2) [3,[10][11][12][17][18][19][35][36][37][38][39][40][41][42][43][44][45][46][47][48][49].…”

Section: Resultsmentioning

confidence: 99%

Immediate versus delayed detection of Takotsubo syndrome after epileptic seizures

Stöllberger

Sauerberg

Finsterer

2019

Journal of the Neurological Sciences

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Takotsubo syndrome(TTS) is often preceded by emotional or physical stress. Epileptic seizures are described in > 100 cases. It is unknown whether patients with immediate and delayed detection of seizure-induced TTS differ.We screened the literature and compared clinical and electrocardiographic (ECG) findings. In 48 cases with seizure-associated TTS, the time between seizure and TTS-detection was reported. Troponin levels were elevated in 37/40. ECG abnormalities were negative T-waves(40%), ST-elevations(33%) and ventricular fibrillation/ flutter(10%). Immediate detection was reported in 23 patients, in the remaining 25 patients, TTS was detected 5-288 h postictally. Patients did not differ in gender, age or symptoms. Negative T-waves were more frequent in patients with delayed detection(64 vs. 13%, p = .0009), whereas ECG-abnormalities suggesting acute myocardial infarction tended to be more prevalent in patients with immediate detection.Due to lack of typical symptoms, seizure-induced TTS can be overlooked. Postictally, an ECG should be recorded and troponin levels measured. New T-wave inversions might indicate seizure-induced TTS.

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Section: Resultsmentioning

confidence: 99%

Immediate versus delayed detection of Takotsubo syndrome after epileptic seizures

Stöllberger

Sauerberg

Finsterer

2019

Journal of the Neurological Sciences

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“…The prognosis of TCM is usually good with complete recovery within a few weeks, but TCM can also be associated with severe complications [21][22][23] such as cardioembolism, cardiac rupture and heart failure. Because of these potential complications, it seems essential to screen for TCM [24] , particularly in post-menopausal women with acute insular or vertebrobasilar stroke or an epileptic focus.…”

Section: Discussionmentioning

confidence: 99%

Takotsubo Cardiomyopathy Following Acute Cerebral Events

et al. 2015

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Objective: Takotsubo cardiomyopathy (TCM) is characterized by transient apical ventricular dysfunction typically induced by acute stress. Acute cerebral events including ischemic stroke (IS) or epileptic events (EEs) may be associated with massive catecholamine release. We aimed to identify the characteristics and outcomes of patients who experienced the Takotsubo syndrome complicated by IS or EE. Methods: Between 2008 and 2013, 87 patients were admitted to our intensive care unit for TCM. Of these, 6 had previously experienced acute cerebral symptoms within 2 days of experiencing either IS or EE. Takotsubo syndrome was diagnosed on cardiac MRI, echocardiography, electrocardiography (ECG), biology and coronary angiography data. Results: Five women and 1 man were included in the study. The mean age was 63.7 ± 20.1 years (range 44-84). Four of them (67%) initially presented an acute IS and 2 (33%) had EE. The suspected brain injury was found in the insular cortex for 4 patients and the posterior fossa for 2 patients. Hemiparesis, aphasia and cerebellar symptoms were the main neurological signs. Abnormal ECG findings including ST-segment elevation (33%) or T-wave inversion (50%) developed between a few hours and 48 h after the onset of the IS or EE. Peak troponin was 1.8 (0.79-14.11) µg/l. A transient reduction in the left ventricular ejection fraction (46 ± 12%) with apical hypokinesis was found using echocardiography. Two (33%) patients went on to develop acute heart failure. Coronary angiography confirmed the lack of significant coronary stenosis for all 6 patients. Conclusion: TCM can develop within the first few days after an acute cerebral event. It occurs predominantly in women with insular or posterior fossa lesions and is possibly induced by vegetative reactions.

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“…Although the loss of consciousness followed by retrograde amnesia cannot allow excluding the fact that our patient also experienced chest pain or dyspnea, it is interesting to observe that TTC triggered by emotional stressors, rather than physical, often tends to present without typical symptoms [ 23 ]. Another interesting issue is that seizures have been reported as causes of TTC [ 24 ]. In particular, it has been reported that patients with seizure-associated TTC tend to be younger, more frequently males, and often present with no chest pain but frequent cardiogenic shock and sudden hemodynamic deterioration [ 25 ].…”

Section: Discussionmentioning

confidence: 99%

Nightmare-Induced Atypical Midventricular Tako-Tsubo Cardiomyopathy

Fibbi

Ballo

et al. 2015

Case Reports in Medicine

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Tako-Tsubo cardiomyopathy (TTC) is a reversible cardiomyopathy characterized by acute left ventricular segmental dysfunction, whose clinical presentation resembles that of acute myocardial infarction. The syndrome often follows a psychophysical stressful event and is characterized by echocardiographic evidence of akinesia of the left ventricular mid-apical segments. Atypical echocardiographic patterns of TTC have recently been described, often triggered by emotional stressors, rather than physical. In this report, we describe a case of atypical TTC triggered by an unusual stressor (recurrent nightmare) in a 45-year-old woman, with peculiar clinical presentation and evolution characterized by persistent loss of consciousness, neurological deterioration, absence of typical symptoms of TTC, and features suggestive of a hysterical crisis.

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Takotsubo cardiomyopathy: a rare, but serious, complication of epileptic seizures

Cited by 14 publications

References 4 publications

Immediate versus delayed detection of Takotsubo syndrome after epileptic seizures

Immediate versus delayed detection of Takotsubo syndrome after epileptic seizures

Takotsubo Cardiomyopathy Following Acute Cerebral Events

Nightmare-Induced Atypical Midventricular Tako-Tsubo Cardiomyopathy

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