Takotsubo Cardiomyopathy in a Vaccinated Patient with Severe COVID-19

Rahimi, Osman; Varada, Neilmegh; Palma, Chriselyn; Al-Taweel, Omar; Lei, KaChon; Hawwass, Dalia; Ahsan, Chowdhury

doi:10.17161/kjm.vol15.16456

Cited by 2 publications

(8 citation statements)

References 6 publications

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“…The diagnosis of TTS requires the exclusion of various differential diagnoses, including myocarditis. REFERENCES 1 Response: Based on the information provided, TTS was suspected to both the acute COVID-19 infection and possibly the vaccine. As documented in our case, IL-6 induced inflammation from the acute viral infection likely caused TTS, 1 but as also cited by Fearon et al 2 , there are cases of vaccine induced TTS, which based on our patient's timeline makes this differential possible.…”

Section: Dear Editormentioning

confidence: 99%

“…Response: Apical hypokinesis is synonymous with ballooning in the setting of basal wall hyperkinesis and it was noted in the report 1 that the findings were collected by a transthoracic echocardiogram. The resolution was after 16 days, which was omitted as it was not relevant for the outcome of the report.…”

Section: Dear Editormentioning

confidence: 99%

“…We read with interest the article by Rahimi et al 1 about a 67-year-old female with symptomatic SARS-CoV-2 infection beginning 10 days prior to admission, administration of the second dose of the Moderna anti-SARS-CoV-2 vaccine four days prior to admission, and admission for respiratory insufficiency (tachycardia, tachypnoea, and hypoxigenation) without fever or cough. Examination for sudden chest pain on hospital day two revealed Takotsubo syndrome (TTS).…”

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confidence: 99%

“…According to the description, echocardiography revealed apical hypokinesia, but no apical ballooning. 1 After how many days did apical ballooning resolve?…”

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confidence: 99%

“…A limitation of the study was that no reference limits for blood tests were specified. 1 Another limitation was that the cardiovascular risk profile was not reported in addition to arterial hypertension. We should know if the patient had diabetes, hyperlipidemia, a history of stroke or myocardial infarction, or if she was smoking.…”

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confidence: 99%

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Before Blaming SARS-CoV-2 Infection or Vaccination for Takotsubo, Differentials Should be Ruled Out

Finsterer¹,

Stöllberger²

2022

kjm

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Section: Dear Editormentioning

confidence: 99%

Section: Dear Editormentioning

confidence: 99%

mentioning

confidence: 99%

“…According to the description, echocardiography revealed apical hypokinesia, but no apical ballooning. 1 After how many days did apical ballooning resolve?…”

mentioning

confidence: 99%

mentioning

confidence: 99%

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Before Blaming SARS-CoV-2 Infection or Vaccination for Takotsubo, Differentials Should be Ruled Out

Finsterer¹,

Stöllberger²

2022

kjm

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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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Takotsubo Cardiomyopathy in a Vaccinated Patient with Severe COVID-19

Cited by 2 publications

References 6 publications

Before Blaming SARS-CoV-2 Infection or Vaccination for Takotsubo, Differentials Should be Ruled Out

Before Blaming SARS-CoV-2 Infection or Vaccination for Takotsubo, Differentials Should be Ruled Out

Takotsubo syndrome and vaccines: a systematic review

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