Takotsubo Cardiomyopathy and COVID-19: A Case Report and Literature
Review

Solís, Juan; Carrizales-Sepúlveda, Edgar Francisco; Vera-Pineda, Raymundo; Morales-Rendón, Eliu Jefte; Ortiz-Corona, Jose de Jesus; Flores-Ramírez, Ramiro

doi:10.2174/1573403x18666220818155039

Cited by 3 publications

(4 citation statements)

References 28 publications

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“…José et al conducted a literature review and identified 71 subjects with TTS and COVID-19 across 35 published reports, in which 18.3% of patients died. 41 Another systematic analysis, which included 52 TTS cases from a total of 40 articles, reported an all-cause mortality rate of 36.5% in TTS patients with COVID-19. 42 Additionally, the European Association of Cardiovascular Imaging found that 2% of 1216 COVID-19 patients included in their analysis had concomitant diagnoses of TTS based on echocardiography findings.…”

Section: Discussionmentioning

confidence: 99%

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Takotsubo syndrome and vaccines: a systematic review

Li,

Peddibhotla

et al. 2024

ESC Heart Failure

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AimsTakotsubo syndrome (TTS) is a rare complication of vaccination. In this study, we sought to provide insight into the characteristics of reported TTS induced by vaccination.Methods and resultsWe did a systematic review, searching PubMed, Embase, Web of Science, Ovid MEDLINE, Journals@Ovid, and Scopus databases up to 26 April 2023 to identify case reports or case series of vaccine‐induced TTS. We then extracted and summarized the data from these reports. Eighteen reports were identified, with a total of 19 patients with TTS associated with vaccinations. Of the 19 included patients, the majority were female (n = 13, 68.4%) with a mean age of 56.6 ± 21.9 years. Seventeen patients developed TTS after coronavirus disease 2019 vaccination, 14 of whom received an mRNA vaccination. Two cases of TTS occurred after influenza vaccination. Among the 19 patients, 17 (89.5%) completed transthoracic echocardiography and 16 (84.2%) underwent angiography procedures. Seven patients (36.8%) completed cardiac magnetic resonance imaging. The median time to symptom onset was 2 (inter‐quartile range, 1–4) days. The most common symptoms were chest pain (68.4%), dyspnoea (57.9%), and digestive symptoms (31.6%). A total of 57.9% of patients developed nonspecific symptoms such as fatigue, myalgia, diaphoresis, and fever. Among the 16 reported cases of TTS, 15 patients (93.8%) exhibited elevated cardiac troponin levels, while among the nine reported cases, eight patients (88.9%) had elevated natriuretic peptide levels. All patients had electrocardiographic changes: ST‐segment change (47.1%), T‐wave inversion (58.8%), and prolonged corrected QT interval (35.3%). The most common TTS type was apical ballooning (88.2%). Treatment during hospitalization typically included beta‐blockers (44.4%), angiotensin‐converting enzyme inhibitors/angiotensin receptor blockers (33.3%), and diuretics (22.2%). After treatment, 81.3% of patients were discharged with improved symptoms. Among this group, nine patients (56.3%) were reported to have recovered ventricular wall motion during follow‐up. Two patients (12.5%) died following vaccination without resuscitation attempts.ConclusionsTTS is a rare but potentially life‐threatening complication of vaccination. Typical TTS symptoms such as chest pain and dyspnoea should be considered alarming symptoms, though nonspecific symptoms are common. The risks of such rare adverse events should be balanced against the risks of infection.

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Section: Discussionmentioning

confidence: 99%

“…José et al . conducted a literature review and identified 71 subjects with TTS and COVID‐19 across 35 published reports, in which 18.3% of patients died 41 . Another systematic analysis, which included 52 TTS cases from a total of 40 articles, reported an all‐cause mortality rate of 36.5% in TTS patients with COVID‐19 42 .…”

Section: Discussionmentioning

confidence: 99%

Takotsubo syndrome and vaccines: a systematic review

Li,

Peddibhotla

et al. 2024

ESC Heart Failure

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“…In these patients, TTS may typically manifest as chest pain (38%) associated with respiratory symptoms, but in few cases with cardiac symptoms only (7.7%). Cardiac troponins are often elevated (>80%) and, notably, in-hospital mortality is high (18%-19%) (3,4).…”

Section: Discussionmentioning

confidence: 99%

Case Report: Asymptomatic SARS-COV2 infection triggering recurrent Takotsubo syndrome

Dall’Ara,

Compagnone,

Carletti

et al. 2024

Front. Cardiovasc. Med.

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Takotsubo syndrome (TTS) is a rare disease mimicking acute coronary syndrome, often triggered by physical or emotional stress, and characterized by transient left ventricular dysfunction. Recurrences are described in about 5% of cases and may have different clinical and imaging patterns. In the present report, SARS-COV-2 infection, even in the absence of symptoms and overt emotional stress, seems correlated with recurrence of TTS, due to the absence of other recognized triggers. The hypothesis is that in predisposed patients, events like catecholamine-induced myocyte injury, direct viral damage, cytokine storm, immune-mediated damage, and procoagulant state, all possibly induced by the infection, may elicit endothelial dysfunction as substrate for TTS onset.

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“…Whether TTS was due to the SARS-CoV-2 infection or due to SARS-CoV-2 vaccination was not discussed. Since both occurred before the suspected onset of TTS and both have been reported as causes of TTS, 2 , 3 it is crucial to delineate whether one or both were causative. It also should be considered whether TTS was triggered by respiratory insufficiency (there was severe hypoxigenation), which can cause severe anxiety, and whether TTS occurred prior to hospitalization or prior to S ARS-CoV-2 vaccination.…”

mentioning

confidence: 99%