Tension pneumothorax-induced Takotsubo syndrome

Abstract

Rationale: Takotsubo syndrome (TTS) is a form of acute and usually reversible heart failure syndrome. Transient left ventricular dysfunction and electrocardiographic changes could mimic acute coronary syndrome but there are actually no obstructive coronary lesions. Patient concerns: A 76-year-old woman with chronic lung disease developed spontaneous tension pneumothorax with the presentation of severe dyspnea, respiratory failure, left ventricular dysfunction, and anterior wall ST-segment elevation on 12-lead electrocardiogram. Acute coronary syndrome was excluded by normal coronary angiograms. Diagnosis: The patient was diagnosed as tension pneumothorax complicated by TTS. Interventions: The woman underwent tubal thoracostomy for tension pneumothorax-induced obstructive shock. However, the patient further underwent ligation bullectomy for persistent air leakage 2 weeks later. Outcomes: The left ventricular dysfunction recovered 1 week after resolution of tension pneumothorax. Anterior wall ST-segment elevation resolved 25 days after admission. Lessons: Concurrent electrocardiograms and echocardiographic serial evaluations should be performed to provide more comprehensive information when dealing with tension pneumothorax patients.

Concomitant Recurrent Pneumothorax and Takotsubo Cardiomyopathy in a Chronic Obstructive Pulmonary Disease Patient

“…Seven cases of pneumothorax and TC have been reported so far including our case (Table 1) [9][10][11][12][13][14]. Except for our case, all cases were female.…”

“…The diagnosis of TC triggered by pneumothorax is challenging because pneumothorax and TC are rarely co-existent, and pneumothorax itself can induce non-specific ECG changes, including ST-segment elevation [ 8 ]. Seven cases of pneumothorax and TC have been reported so far including our case (Table 1 ) [ 9 - 14 ]. Except for our case, all cases were female.…”

Stress-induced cardiomyopathy with electrocardiographic ST-segment elevation in a patient with pneumothorax

“…After searching in the English literature, only six cases were found to be reported. [13,[15][16][17][18][19] A brief analysis of these cases showed that, unlike in our case, all patients were women, with ages ranging from 58.0 to 83.0 years (average 69.5 years). Among these, three had tension pneumothorax, and four had pneumothorax on the right side.…”

Acupuncture-Induced Tension Pneumothorax Presenting as Acute Heart Failure

“…To our knowledge, this is the first reported case of TSS secondary to an acupuncture-induced tension pneumothorax Case Reports in Cardiology [8][9][10][11][12]. This case illustrates that TSS is often caused by a physical or emotional stressor, which should be diagnosed and treated immediately.…”