A myasthenic crisis of broken hearts (reverse takotsubo): Case report and review of literature

J R Coll Physicians Edinb. 2022 Mar;52(1):27-29. doi: 10.1177/14782715221088913.

Abstract

Myasthenic crisis (MC) is rarely associated with takotsubo cardiomyopathy (TTC), but embolic complications of MC-associated reverse TTC are yet to be documented. We present a case of a 70-year-old Caucasian female with MC-associated reverse TTC, developing acute cerebral infarcts. Following aggressive treatment with immunoglobulins and anticholinergics, cardiac function normalised. TTC is an important differential diagnosis in acute deteriorations of cardiac function, particularly in intensive care, not only due to frequent use of inotropes and embolic complications but also because cardiac function is reversible with good medical care. Early specialist neurologist and cardiologist input should be sought in such cases.

Keywords: apical ballooning syndrome; broken-heart syndrome; case report; myasthenic crisis; stress cardiomyopathy; takotsubo cardiomyopathy.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Aged
  • Cholinergic Antagonists
  • Female
  • Heart
  • Humans
  • Myasthenia Gravis* / complications
  • Myasthenia Gravis* / diagnosis
  • Takotsubo Cardiomyopathy* / complications
  • Takotsubo Cardiomyopathy* / diagnosis

Substances

  • Cholinergic Antagonists