Skip to main content
Top
Published in: BMC Pregnancy and Childbirth 1/2019

Open Access 01-12-2019 | Cardiomyopathy | Case report

Takotsubo cardiomyopathy in pregnancy: a case report and literature review

Authors: Felix Mwembi Oindi, Evan Sequeira, Herman Ryan Sequeira, Steve Kyende Mutiso

Published in: BMC Pregnancy and Childbirth | Issue 1/2019

Login to get access

Abstract

Background

Takotsubo cardiomyopathy is rare in pregnancy and is characterized by left ventricular dysfunction with apical ballooning. This transient cardiac dysfunction may affect women of childbearing age in the antepartum, intrapartum or postpartum period. Most patients respond well to medical management with resolution of cardiac dysfunction within weeks.

Case presentation

A 35-year-old female in her second pregnancy presented with severe preeclampsia at 31 weeks of gestation. She subsequently developed severe substernal chest pain and workup showed a stress induced cardiomyopathy prior to her delivery via caesarean section. She had full recovery of her cardiac function by 12 weeks postpartum after medical management.

Conclusions

Stress induced cardiomyopathy, though rare, should be considered after acute myocardial infarction has been ruled out in gravid females presenting with acute chest pain. Management should involve a multidisciplinary team. Cardiac function recovery is common within 4 weeks although some patients may require long term heart failure management.
Literature
1.
go back to reference Templin C, Ghadri JR, Diekmann J, Napp LC, Bataiosu DR, Jaguszewski M, et al. Clinical features and outcomes of Takotsubo (stress) cardiomyopathy. N Engl J Med. 2015;373(10):929–38.CrossRef Templin C, Ghadri JR, Diekmann J, Napp LC, Bataiosu DR, Jaguszewski M, et al. Clinical features and outcomes of Takotsubo (stress) cardiomyopathy. N Engl J Med. 2015;373(10):929–38.CrossRef
2.
go back to reference Minatoguchi M, Itakura A, Takagi E, Nishibayashi M, Kikuchi M, Ishihara O. Takotsubo cardiomyopathy after cesarean: a case report and published work review of pregnancy-related cases. J Obstet Gynaecol Res. 2014;40(6):1534–9.CrossRef Minatoguchi M, Itakura A, Takagi E, Nishibayashi M, Kikuchi M, Ishihara O. Takotsubo cardiomyopathy after cesarean: a case report and published work review of pregnancy-related cases. J Obstet Gynaecol Res. 2014;40(6):1534–9.CrossRef
3.
go back to reference Salmoirago-Blotcher E, Dunsiger S, Swales HH, Aurigemma GP, Ockene I, Rosman L, et al. Reproductive history of women with Takotsubo cardiomyopathy. Am J Cardiol. 2016;118(12):1922–8.CrossRef Salmoirago-Blotcher E, Dunsiger S, Swales HH, Aurigemma GP, Ockene I, Rosman L, et al. Reproductive history of women with Takotsubo cardiomyopathy. Am J Cardiol. 2016;118(12):1922–8.CrossRef
4.
go back to reference Pelliccia F, Kaski JC, Crea F, Camici PG. Pathophysiology of Takotsubo syndrome. Circulation. 2017;135(24):2426–41.CrossRef Pelliccia F, Kaski JC, Crea F, Camici PG. Pathophysiology of Takotsubo syndrome. Circulation. 2017;135(24):2426–41.CrossRef
5.
go back to reference Yaqub Y, Jenkins LA, Nugent KM, Chokesuwattanaskul W. Postpartum depression and apical ballooning syndrome (takotsubo syndrome). J Obstet Gynaecol Can. 2009;31(8):736–9.CrossRef Yaqub Y, Jenkins LA, Nugent KM, Chokesuwattanaskul W. Postpartum depression and apical ballooning syndrome (takotsubo syndrome). J Obstet Gynaecol Can. 2009;31(8):736–9.CrossRef
6.
go back to reference Nayeri A, Rafla-Yuan E, Farber-Eger E, Blair M, Ziaeian B, Cadeiras M, et al. Pre-existing psychiatric illness is associated with increased risk of recurrent Takotsubo cardiomyopathy. Psychosomatics. 2017. Nayeri A, Rafla-Yuan E, Farber-Eger E, Blair M, Ziaeian B, Cadeiras M, et al. Pre-existing psychiatric illness is associated with increased risk of recurrent Takotsubo cardiomyopathy. Psychosomatics. 2017.
7.
go back to reference Corrigan FE 3rd, Kimmel MC, Jayaram G. Four cases of takotsubo cardiomyopathy linked with exacerbations of psychiatric illness. Innov Clin Neurosci. 2011;8(7):50–3.PubMedPubMedCentral Corrigan FE 3rd, Kimmel MC, Jayaram G. Four cases of takotsubo cardiomyopathy linked with exacerbations of psychiatric illness. Innov Clin Neurosci. 2011;8(7):50–3.PubMedPubMedCentral
8.
go back to reference Virani SS, Khan AN, Mendoza CE, Ferreira AC, de Marchena E. Takotsubo cardiomyopathy, or broken-heart syndrome. Tex Heart Inst J. 2007;34(1):76–9.PubMedPubMedCentral Virani SS, Khan AN, Mendoza CE, Ferreira AC, de Marchena E. Takotsubo cardiomyopathy, or broken-heart syndrome. Tex Heart Inst J. 2007;34(1):76–9.PubMedPubMedCentral
9.
go back to reference Ruiz S, Martinez-Marin M, Luque P, Nassar N, Oros D. Takotsubo cardiomyopathy after cesarean section: a case report and literature review. J Obstet Gynaecol Res. 2017;43(2):392–6.CrossRef Ruiz S, Martinez-Marin M, Luque P, Nassar N, Oros D. Takotsubo cardiomyopathy after cesarean section: a case report and literature review. J Obstet Gynaecol Res. 2017;43(2):392–6.CrossRef
10.
go back to reference Suzuki T, Nemoto C, Ikegami Y, Yokokawa T, Tsukada Y, Abe Y, et al. Development of takotsubo cardiomyopathy with severe pulmonary edema before a cesarean section. J Anesth. 2014;28(1):121–4.CrossRef Suzuki T, Nemoto C, Ikegami Y, Yokokawa T, Tsukada Y, Abe Y, et al. Development of takotsubo cardiomyopathy with severe pulmonary edema before a cesarean section. J Anesth. 2014;28(1):121–4.CrossRef
11.
go back to reference Smith JM, Lowe RF, Fullerton J, Currie SM, Harris L, Felker-Kantor E. An integrative review of the side effects related to the use of magnesium sulfate for pre-eclampsia and eclampsia management. BMC Pregnancy Childbirth. 2013;13:34.CrossRef Smith JM, Lowe RF, Fullerton J, Currie SM, Harris L, Felker-Kantor E. An integrative review of the side effects related to the use of magnesium sulfate for pre-eclampsia and eclampsia management. BMC Pregnancy Childbirth. 2013;13:34.CrossRef
12.
go back to reference Chollat C, Le Doussal L, de la Villeon G, Provost D, Marret S. Antenatal magnesium sulphate administration for fetal neuroprotection: a French national survey. BMC Pregnancy Childbirth. 2017;17(1):304.CrossRef Chollat C, Le Doussal L, de la Villeon G, Provost D, Marret S. Antenatal magnesium sulphate administration for fetal neuroprotection: a French national survey. BMC Pregnancy Childbirth. 2017;17(1):304.CrossRef
13.
go back to reference Zdanowicz JA, Utz AC, Bernasconi I, Geier S, Corti R, Beinder E. "broken heart" after cesarean delivery. Case report and review of literature. Arch Gynecol Obstet. 2011;283(4):687–94.CrossRef Zdanowicz JA, Utz AC, Bernasconi I, Geier S, Corti R, Beinder E. "broken heart" after cesarean delivery. Case report and review of literature. Arch Gynecol Obstet. 2011;283(4):687–94.CrossRef
14.
go back to reference Picariello C, Lazzeri C, Attana P, Chiostri M, Gensini GF, Valente S. The impact of hypertension on patients with acute coronary syndromes. Int J Hypertens. 2011;2011:563657.CrossRef Picariello C, Lazzeri C, Attana P, Chiostri M, Gensini GF, Valente S. The impact of hypertension on patients with acute coronary syndromes. Int J Hypertens. 2011;2011:563657.CrossRef
15.
go back to reference Otani Y, Tokunaga K, Kawauchi S, Inoue S, Watanabe K, Kiriyama H, et al. Cerebral infarction arising from Takotsubo cardiomyopathy: case report and literature review. NMC Case Rep J. 2016;3(4):119–23.CrossRef Otani Y, Tokunaga K, Kawauchi S, Inoue S, Watanabe K, Kiriyama H, et al. Cerebral infarction arising from Takotsubo cardiomyopathy: case report and literature review. NMC Case Rep J. 2016;3(4):119–23.CrossRef
16.
go back to reference Rozema T, Klein LR. Takotsubo cardiomyopathy: a case report and literature review. Cardiol Young. 2016;26(2):406–9.CrossRef Rozema T, Klein LR. Takotsubo cardiomyopathy: a case report and literature review. Cardiol Young. 2016;26(2):406–9.CrossRef
17.
go back to reference Gupta S, Gupta MM. Takotsubo syndrome. Indian Heart J. 2018;70(1):165–74.CrossRef Gupta S, Gupta MM. Takotsubo syndrome. Indian Heart J. 2018;70(1):165–74.CrossRef
18.
go back to reference Roshanzamir S, Showkathali R. Takotsubo cardiomyopathy a short review. Curr Cardiol Rev. 2013;9(3):191–6.CrossRef Roshanzamir S, Showkathali R. Takotsubo cardiomyopathy a short review. Curr Cardiol Rev. 2013;9(3):191–6.CrossRef
19.
go back to reference Yalta K, Yilmaztepe M, Zorkun C. Left ventricular dysfunction in the setting of Takotsubo cardiomyopathy: a review of clinical patterns and practical implications. Card Fail Rev. 2018;4(1):14–20.CrossRef Yalta K, Yilmaztepe M, Zorkun C. Left ventricular dysfunction in the setting of Takotsubo cardiomyopathy: a review of clinical patterns and practical implications. Card Fail Rev. 2018;4(1):14–20.CrossRef
20.
go back to reference De Backer O, Debonnaire P, Gevaert S, Missault L, Gheeraert P, Muyldermans L. Prevalence, associated factors and management implications of left ventricular outflow tract obstruction in takotsubo cardiomyopathy: a two-year, two-center experience. BMC Cardiovasc Disord. 2014;14:147.CrossRef De Backer O, Debonnaire P, Gevaert S, Missault L, Gheeraert P, Muyldermans L. Prevalence, associated factors and management implications of left ventricular outflow tract obstruction in takotsubo cardiomyopathy: a two-year, two-center experience. BMC Cardiovasc Disord. 2014;14:147.CrossRef
21.
go back to reference Hefner J, Csef H, Frantz S, Glatter N, Warrings B. Recurrent Tako-Tsubo cardiomyopathy (TCM) in a pre-menopausal woman: late sequelae of a traumatic event? BMC Cardiovasc Disord. 2015;15:3.CrossRef Hefner J, Csef H, Frantz S, Glatter N, Warrings B. Recurrent Tako-Tsubo cardiomyopathy (TCM) in a pre-menopausal woman: late sequelae of a traumatic event? BMC Cardiovasc Disord. 2015;15:3.CrossRef
Metadata
Title
Takotsubo cardiomyopathy in pregnancy: a case report and literature review
Authors
Felix Mwembi Oindi
Evan Sequeira
Herman Ryan Sequeira
Steve Kyende Mutiso
Publication date
01-12-2019
Publisher
BioMed Central
Published in
BMC Pregnancy and Childbirth / Issue 1/2019
Electronic ISSN: 1471-2393
DOI
https://doi.org/10.1186/s12884-019-2233-7

Other articles of this Issue 1/2019

BMC Pregnancy and Childbirth 1/2019 Go to the issue