Left Ventricular Thrombus Associated with Takotsubo Cardiomyopathy: A Cardioembolic Cause of Cerebral Infarction

Abstract

Takotsubo cardiomyopathy, also called stress-induced cardiomyopathy, usually occurs in patients with severe emotional or physiologic stress. The prognosis is favorable, and the wall motion abnormlities normalize within weeks. However, stress-induced cardiomyopathy is rarely assosicated with left ventricular thrombus and thromboembolic complications. Here, we report a case of stress-induced cardiomyopathy with left ventricular thrombus that embolized to cause cerebral infarction.

Which is first? Whether Takotsubo cardiomyopathy was complicated with acute stroke or acute stroke caused Takotsubo cardiomyopathy? A case report

“…TCMP may develop due to the acute stroke. In addition, patients with TCMP may have left ventricular apical thrombus that may lead to the acute ischemic stroke (3)(4)(5). In this case, we detected TCMP in patient with acute ischemic stroke and complete aphasia.…”

Stress-induced cardiomyopathy (Takotsubo) – broken heart and mind?

“…The reader should note that restricting the diagnosis of SIC to patients presenting with the typical apical variant may have caused the authors to underestimate the prevalence of SIC in these patients. There exists a two-way relationship between ischemic stroke and SIC, in the sense that ischemic stroke may be either the cause or the consequence of SIC 30–32. Although thrombus formation may occur rather frequently within the akinetic left ventricle, thromboembolic complications appear to be less common 33.…”

Takotsubo cardiomyopathy in a man with no trigger and multiple cardioembolic complications—A rare constellation

“…11 Contrary to previous notions, only 1/3rd of cases have emotional triggers. 3,[23][24][25] Cardioembolic events have been seen in about 1% of patients 23,26 and TC complicated by LV thrombus has a 92% female predominance; only one case has been reported in the literature with a renal infarct. 12 Acute prognosis is also worse than initially believed, 13 with in-hospital rates of death and shock being similar to age-and sex-matched ACS patients.…”

“…Persistence to 6 months in one study was shown to be correlated with higher levels of myocardial damage by enzyme elevation, worse wall-motion abnormalities, and poorer outcomes including heart failure. [23][24][25] Multimodality imaging with echocardiography, CCTA, and CMR was key to making the correct diagnosis. 39 Our patient had a unique constellation of several unusual features of this uncommon disease-male sex, no emotional or physical trigger, LV thrombus on presentation, and 3 sites of cardio-embolism (brain, kidney, and lower extremity).…”