A Case of Posterior Reversible Encephalopathy Due to Takotsubo Cardiomyopathy Triggered by Aerophobia

Güldeniz Çetin; Esra Nur Sancar; Serkan Demir; Özdem Ertürk Çetin; Sevki Sahin

doi:10.7759/cureus.40678

A Case of Posterior Reversible Encephalopathy Due to Takotsubo Cardiomyopathy Triggered by Aerophobia

Cureus. 2023 Jun 20;15(6):e40678. doi: 10.7759/cureus.40678. eCollection 2023 Jun.

Authors

Güldeniz Çetin¹, Esra Nur Sancar¹, Serkan Demir², Özdem Ertürk Çetin¹, Sevki Sahin³

Affiliations

¹ Neurology, Dr. İlhan Varank Sancaktepe Research and Training Hospital, Istanbul, TUR.
² Neurology, Sancaktepe Sehit Prof. Dr. Ilhan Varank Training and Research Hospital, İstanbul, TUR.
³ Neurology, University of Health Sciences, Sancaktepe Şehit Prof. Dr. İlhan Varank Training and Research Hospital, İstanbul, TUR.

Abstract

A 37-year-old woman, previously known to have severe airplane phobia, develops panic disorder-like symptoms in the second hour of the flight. After a while, panic disorder was accompanied by chest pain and syncope. An ECG showed no abnormalities. Transthoracic echocardiogram demonstrated decreased left ventricular ejection fraction (EF: 30), large apical akinesis, and characteristic regional wall motion abnormalities involving the middle and apical segments of the left ventricle. Findings were consistent with Takotsubo cardiomyopathy. But in the emergency department, Brain Diffusion MRI showed cortical and subcortical vasogenic edema in the posterior regions, predominantly on the left, bilaterally, compatible with posterior reversible encephalopathy. This case highlights the Takotsubo cardiomyopathy-related posterior reversible encephalopathy syndrome (PRES) syndrome and managing the disease.

Keywords: heart failure; loss of conciousness; posterior reversible encephalopathy syndrome (pres); tako-tsubo cardiomyopathy (ttc); unexplained syncope.

Publication types

Case Reports