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Reverse Takotsubo cardiomyopathy associated with tonic clonic seizure: a rare form of Takotsubo cardiomyopathy
  1. Usman Ali1,
  2. Arsalan Khalil2,
  3. Sagar N Doshi3 and
  4. Adnan Nadir4
  1. 1Cardiology, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
  2. 2Critical Care, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
  3. 3Cardiology, University Hospitals Birmingham, Birmingham, West Midlands, UK
  4. 4Cardiology, University Hospitals Birmingham NHS Foundation Trust, Birmingham, West Midlands, UK
  1. Correspondence to Dr Usman Ali; usman.ali8{at}


A woman in her 30s presented with generalised tonic clonic seizure secondary to known pilocytic astrocytoma. This seizure activity resolved spontaneously after 5 min. On clinical assessment, she was neurologically stable and further neurological investigations did not reveal progression of previously recognised pilocytic astrocytoma. Incidentally, she was found to have an elevated troponin, which significantly increased on serial assessment. ECG was unremarkable and echocardiography revealed regional wall motion abnormalities involving basal segments of the left ventricle with apical sparing. She underwent cardiac MRI, which confirmed the presence of regional wall motion abnormalities seen on echocardiography; however, there was no evidence of myocardial oedema or late gadolinium enhancement. Subsequently, she had an invasive coronary angiogram with intravascular ultrasound which ruled out acute coronary plaque event and coronary dissection. In view of the above, a diagnosis of reverse Takotsubo cardiomyopathy was made. This is a relatively rare entity characterised by the presence of akinesia/hypokinesia in the basal segments with preserved apical contractility; often seen in younger patients.

  • Interventional cardiology
  • Clinical diagnostic tests
  • Epilepsy and seizures

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  • Contributors UA—joint first author—conceptualisation, data collection, article writing and proof-reading. AK—joint first author—conceptualisation, data collection, article writing and proof-reading. SND—conceptualisation, supervision, proof-reading. AN—conceptualisation, supervision, proof-reading.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.