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Percutaneous left ventricular assistance in cardiogenic shock due to Takotsubo cardiomyopathy secondary to status epilepticus
  1. Cristina Martins1,
  2. Ricardo Meireles Mateus1,
  3. Diogo Cunha2 and
  4. Rui Gomes1
  1. 1Intensive Care Unit, Garcia de Orta Hospital, Almada, Portugal
  2. 2Cardiology, Garcia de Orta Hospital, Almada, Portugal
  1. Correspondence to Dr Cristina Martins; ana.maia.martins{at}hgo.min-saude.pt

Abstract

Takotsubo syndrome is an acute reversible cardiomyopathy with left ventricular dysfunction and a clinical presentation similar to an acute coronary syndrome. Emotional or physical triggers can cause it, including neurological conditions such as seizures. We describe a case of a woman in her 50s with Takotsubo syndrome secondary to status epilepticus, presenting with cardiac arrest and cardiogenic shock. We excluded acute coronary syndrome with coronary angiography. Despite inotropic support, she remained haemodynamically unstable and a percutaneous left ventricular assistance with an Impella CP catheter was initiated. This resulted in a quick weaning of haemodynamic support and recovery of left ventricle systolic function in 2 weeks. This case illustrates the importance of a high index of suspicion to make this diagnosis and link it to neurological triggers, as well as to consider mechanical circulatory support in managing cardiogenic shock due to this cardiomyopathy.

  • Interventional cardiology
  • Epilepsy and seizures
  • Heart failure

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Footnotes

  • Contributors CM, RMM, DC and RG were directly involved in the patient clinical examination and treatment. CM did the literature review and wrote the manuscript. RG did the text and images revision and approved the final version.

  • 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.