Cardiogenic shock induced by Takotsubo cardiomyopathy: A new therapeutic option

Abstract

Takotsubo cardiomyopathy (TC) is characterized by the sudden onset of reversible left ventricular dysfunction, with a presentation similar to that of an acute coronary syndrome. Although cardiogenic shock is a rare occurrence in TC, if it does occur it may require the use of a left ventricular assist device. We report the use of extracorporeal life support (ECLS) in a patient with TC and refractory cardiogenic shock. With ECLS it was possible to reduce inotropic support, and a normal left ventricular ejection fraction was documented by echocardiography on day 2. This is, to our knowledge, the first reported case of TC with refractory cardiogenic shock treated with ECLS in Portugal.

Takotsubo syndrome and coronary vasospasm: Two faces of the same coin?

“…As described in this case report, and in accordance with the current guidelines, the presence of both these entities can have therapeutic importance 1, 11. In TTS, the possible role of cathecolamine-induced cardiac damage is highlighted in the current European Society of Cardiology position paper, where avoidance of inotropes (such as noradrenaline and adrenaline) should be considered, 1 as this could further worsen the patient’s clinical status 1, 12. On the other hand, in patients with reduced LVEF (such as the case presented), beta-blockade should be considered 1 .…”

Successful use of extracorporeal membrane oxygenation support in severe septic shock with associated acute cardiomyopathy

“…However, for patients who survive, SICM usually resolves in 7 to 10 days . Takotsubo cardiomyopathy is typically reversible without high morbidity or mortality, and rarely progresses to fulminant cardiogenic shock …”