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Published in: Journal of Medical Case Reports 1/2019

Open Access 01-12-2019 | Guillain-Barré Syndrome | Case report

Reversible stress cardiomyopathy in Guillain-Barré syndrome: a case report

Authors: A. Gravos, A. Destounis, K. Katsifa, P. Tselioti, K. Sakellaridis, V. Grammatikopoulou, C. Tsapas, A. Nodarou, P. Batiani, A. Prekates

Published in: Journal of Medical Case Reports | Issue 1/2019

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Abstract

Background

Guillain-Barré syndrome is an autoimmune disorder in which autoantibodies mainly affect the peripheral nervous system. Autonomic dysfunction is a common and severe complication of Guillain-Barré syndrome. Cardiomyopathy, though, is a rare complication in Guillain-Barré syndrome, with only a few cases reported in the literature.

Case Presentation

We present a case of a 65-year-old Greek woman with Guillain-Barré syndrome who developed cardiomyopathy shortly after admission to the intensive care unit due to respiratory deterioration. Her estimated left ventricular ejection fraction upon admission was 20%. The result of coronary angiography was negative for coronary artery disease, and cardiac magnetic resonance imaging excluded myocarditis. Her clinical condition improved with supportive therapy, and her estimated left ventricular ejection fraction at discharge was normal.

Conclusions

Clinicians should be aware of this potentially lethal complication of Guillain-Barré syndrome and the therapeutic options, because early diagnosis can improve prognosis. Routine electrocardiographic and echocardiographic assessments should be performed in patients with Guillain-Barré syndrome presenting with hemodynamic instability.
Literature
1.
2.
go back to reference Anandan C, Khuder SA, Koffman BM. Prevalence of autonomic dysfunction in hospitalized patients with Guillain-Barré syndrome. Muscle Nerve. 2017;56(2):331–3.CrossRef Anandan C, Khuder SA, Koffman BM. Prevalence of autonomic dysfunction in hospitalized patients with Guillain-Barré syndrome. Muscle Nerve. 2017;56(2):331–3.CrossRef
3.
go back to reference Flachenecker P. Autonomic dysfunction in Guillain-Barré syndrome and multiple sclerosis. J Neurol. 2007;254(Suppl 2):II96–II101.PubMed Flachenecker P. Autonomic dysfunction in Guillain-Barré syndrome and multiple sclerosis. J Neurol. 2007;254(Suppl 2):II96–II101.PubMed
4.
go back to reference Mukerji S, Aloka F, Farooq MU, et al. Cardiovascular complications of the Guillain-Barré syndrome. Am J Cardiol. 2009;104:1452–5.CrossRef Mukerji S, Aloka F, Farooq MU, et al. Cardiovascular complications of the Guillain-Barré syndrome. Am J Cardiol. 2009;104:1452–5.CrossRef
5.
go back to reference Bernstein R, Mayer SA, Magnano A. Neurogenic stunned myocardium in Guillain-Barré syndrome. Neurology. 2000;54:759–62.CrossRef Bernstein R, Mayer SA, Magnano A. Neurogenic stunned myocardium in Guillain-Barré syndrome. Neurology. 2000;54:759–62.CrossRef
6.
go back to reference Finkelstein JS, Melek BH. Guillain-Barré syndrome as a cause of reversible cardiomyopathy. Tex Heart Inst J. 2006;33:57–9.PubMedPubMedCentral Finkelstein JS, Melek BH. Guillain-Barré syndrome as a cause of reversible cardiomyopathy. Tex Heart Inst J. 2006;33:57–9.PubMedPubMedCentral
7.
go back to reference Oomura M, Yamawaki T, Oe H, et al. Association of cardiomyopathy caused by autonomic nervous system impairment with the Miller Fisher syndrome. J Neurol Neurosurg Psychiatry. 2003;74:689–90.CrossRef Oomura M, Yamawaki T, Oe H, et al. Association of cardiomyopathy caused by autonomic nervous system impairment with the Miller Fisher syndrome. J Neurol Neurosurg Psychiatry. 2003;74:689–90.CrossRef
8.
go back to reference Palazzuoli A, Lenci C, Iovine F, et al. A case of acute heart failure associated with Guillain-Barré syndrome. Neurol Sci. 2006;26:447–50.CrossRef Palazzuoli A, Lenci C, Iovine F, et al. A case of acute heart failure associated with Guillain-Barré syndrome. Neurol Sci. 2006;26:447–50.CrossRef
9.
go back to reference Iga K, Himura Y, Izumi C, et al. Reversible left ventricular dysfunction associated with Guillain–Barré syndrome—an expression of catecholamine cardiotoxicity? Jpn Circ J. 1995;59(4):236–40.CrossRef Iga K, Himura Y, Izumi C, et al. Reversible left ventricular dysfunction associated with Guillain–Barré syndrome—an expression of catecholamine cardiotoxicity? Jpn Circ J. 1995;59(4):236–40.CrossRef
10.
go back to reference Rousseff RT, Al-Khashan S, Khuraibet AJ. Transient cardiomyopathy as the presenting feature of Guillain-Barré syndrome. J Peripher Nerv Syst. 2010;15:153–5.CrossRef Rousseff RT, Al-Khashan S, Khuraibet AJ. Transient cardiomyopathy as the presenting feature of Guillain-Barré syndrome. J Peripher Nerv Syst. 2010;15:153–5.CrossRef
11.
go back to reference Gill D, Ruiz VG, Dean R, et al. Takotsubo cardiomyopathy with Guillain-Barré syndrome. Proc (Bayl Univ Med Cent). 2017;30(3):307–8.CrossRef Gill D, Ruiz VG, Dean R, et al. Takotsubo cardiomyopathy with Guillain-Barré syndrome. Proc (Bayl Univ Med Cent). 2017;30(3):307–8.CrossRef
12.
go back to reference Martins R, Barbarot N, Coquerel N, et al. Takotsubo cardiomyopathy associated with Guillain-Barré syndrome: a differential diagnosis from dysautonomia not to be missed. J Neurol Sci. 2010;291:100–2.CrossRef Martins R, Barbarot N, Coquerel N, et al. Takotsubo cardiomyopathy associated with Guillain-Barré syndrome: a differential diagnosis from dysautonomia not to be missed. J Neurol Sci. 2010;291:100–2.CrossRef
13.
go back to reference Flachenecker P, Hartung HP, Reiners K. Power spectrum analysis of heart rate variability in Guillain–Barré syndrome: a longitudinal study. Brain. 1997;120(Pt 10):1885–94.CrossRef Flachenecker P, Hartung HP, Reiners K. Power spectrum analysis of heart rate variability in Guillain–Barré syndrome: a longitudinal study. Brain. 1997;120(Pt 10):1885–94.CrossRef
14.
go back to reference Elliott P, Andersson B, Arbustini E, et al. Classification of the cardiomyopathies: a position statement from the European Society of Cardiology Working Group on Myocardial and Pericardial Diseases. Eur Heart J. 2008;29:270–6.CrossRef Elliott P, Andersson B, Arbustini E, et al. Classification of the cardiomyopathies: a position statement from the European Society of Cardiology Working Group on Myocardial and Pericardial Diseases. Eur Heart J. 2008;29:270–6.CrossRef
15.
go back to reference Yoshikawa T. Takotsubo cardiomyopathy, a new concept of cardiomyopathy: clinical features and pathophysiology. Int J Cardiol. 2015;182:297–303.CrossRef Yoshikawa T. Takotsubo cardiomyopathy, a new concept of cardiomyopathy: clinical features and pathophysiology. Int J Cardiol. 2015;182:297–303.CrossRef
16.
go back to reference Madias JE. Why the current diagnostic criteria of takotsubo syndrome are outmoded: a proposal for new criteria. Int J Cardiol. 2014;174:468–70.CrossRef Madias JE. Why the current diagnostic criteria of takotsubo syndrome are outmoded: a proposal for new criteria. Int J Cardiol. 2014;174:468–70.CrossRef
17.
go back to reference Patel H, Madanieh R, Kosmas CE, et al. Reversible cardiomyopathies. Clin Med Insights Cardiol. 2015;21:7–14. Patel H, Madanieh R, Kosmas CE, et al. Reversible cardiomyopathies. Clin Med Insights Cardiol. 2015;21:7–14.
18.
go back to reference Lyon AR, Rees PS, Prasad S, et al. Stress (takotsubo) cardiomyopathy—a novel pathophysiological hypothesis to explain catecholamine induced acute myocardial stunning. Nat Clin Pract Cardiovasc Med. 2008;5(1):22–9.CrossRef Lyon AR, Rees PS, Prasad S, et al. Stress (takotsubo) cardiomyopathy—a novel pathophysiological hypothesis to explain catecholamine induced acute myocardial stunning. Nat Clin Pract Cardiovasc Med. 2008;5(1):22–9.CrossRef
19.
go back to reference Ibrahim K, Jellinghaus S, Christoph M, et al. Intracranial hemorrhage causes a transmural myocardial infarction without the presence of coronary atherosclerosis. Int J Cardiol. 2011;152(2):e40–1.CrossRef Ibrahim K, Jellinghaus S, Christoph M, et al. Intracranial hemorrhage causes a transmural myocardial infarction without the presence of coronary atherosclerosis. Int J Cardiol. 2011;152(2):e40–1.CrossRef
20.
go back to reference Seifert T, Klein E, Legat-Wallner S, et al. Bilateral vertebral artery dissection and infratentorial stroke complicated by stress-induced cardiomyopathy. J Neurol Neurosurg Psychiatry. 2008;79:480–1.CrossRef Seifert T, Klein E, Legat-Wallner S, et al. Bilateral vertebral artery dissection and infratentorial stroke complicated by stress-induced cardiomyopathy. J Neurol Neurosurg Psychiatry. 2008;79:480–1.CrossRef
21.
go back to reference Wang TD, Wu CC, Lee YT. Myocardial stunning after cerebral infarction. Int J Cardiol. 1997;58:308–11.CrossRef Wang TD, Wu CC, Lee YT. Myocardial stunning after cerebral infarction. Int J Cardiol. 1997;58:308–11.CrossRef
22.
go back to reference Tamsin G, Smith M. Cardiovascular complications of brain injury. BJA Educ. 2012;12:67–71. Tamsin G, Smith M. Cardiovascular complications of brain injury. BJA Educ. 2012;12:67–71.
23.
go back to reference Guglin M, Novotorova I. Neurogenic stunned myocardium and takotsubo cardiomyopathy are the same syndrome: a pooled analysis. Congest Heart Fail. 2011;17:127–32.CrossRef Guglin M, Novotorova I. Neurogenic stunned myocardium and takotsubo cardiomyopathy are the same syndrome: a pooled analysis. Congest Heart Fail. 2011;17:127–32.CrossRef
24.
go back to reference Finsterer J, Wahbi K. CNS disease triggering takotsubo stress cardiomyopathy. Int J Cardiol. 2014;177:322–9.CrossRef Finsterer J, Wahbi K. CNS disease triggering takotsubo stress cardiomyopathy. Int J Cardiol. 2014;177:322–9.CrossRef
25.
go back to reference Szardien S, Möllmann H, Willmer M, et al. Mechanisms of stress (takotsubo) cardiomyopathy. Heart Fail Clin. 2013;9:197–205.CrossRef Szardien S, Möllmann H, Willmer M, et al. Mechanisms of stress (takotsubo) cardiomyopathy. Heart Fail Clin. 2013;9:197–205.CrossRef
26.
go back to reference Havel C, Arrich J, Losert H, et al. Vasopressors for hypotensive shock. Cochrane Database Syst Rev. 2011;5:CD003709. Havel C, Arrich J, Losert H, et al. Vasopressors for hypotensive shock. Cochrane Database Syst Rev. 2011;5:CD003709.
27.
go back to reference Quick S, Quick C, Schneider R, et al. Guillain-Barrι syndrome and catecholamine therapy: a potential risk for developing takotsubo cardiomyopathy? Int J Cardiol. 2013;165:43–4.CrossRef Quick S, Quick C, Schneider R, et al. Guillain-Barrι syndrome and catecholamine therapy: a potential risk for developing takotsubo cardiomyopathy? Int J Cardiol. 2013;165:43–4.CrossRef
28.
go back to reference Ono R, Falcão LM. Takotsubo cardiomyopathy systematic review: pathophysiologic process, clinical presentation and diagnostic approach to Takotsubo cardiomyopathy. Int J Cardiol. 2016;209:196–205.CrossRef Ono R, Falcão LM. Takotsubo cardiomyopathy systematic review: pathophysiologic process, clinical presentation and diagnostic approach to Takotsubo cardiomyopathy. Int J Cardiol. 2016;209:196–205.CrossRef
29.
go back to reference Lazaridis C, Pradilla G, Nyquist PA, et al. Intra-aortic balloon pump counterpulsation in the setting of subarachnoid hemorrhage, cerebral vasospasm, and neurogenic stress cardiomyopathy: case report and review of the literature. Neurocrit Care. 2010;13:101–8.CrossRef Lazaridis C, Pradilla G, Nyquist PA, et al. Intra-aortic balloon pump counterpulsation in the setting of subarachnoid hemorrhage, cerebral vasospasm, and neurogenic stress cardiomyopathy: case report and review of the literature. Neurocrit Care. 2010;13:101–8.CrossRef
30.
go back to reference Naidech A, Du Y, Kreiter KT, et al. Dobutamine versus milrinone after subarachnoid hemorrhage. Neurosurgery. 2005;56:21–6l.CrossRef Naidech A, Du Y, Kreiter KT, et al. Dobutamine versus milrinone after subarachnoid hemorrhage. Neurosurgery. 2005;56:21–6l.CrossRef
31.
go back to reference Busani S, Rinaldi L, Severino C, et al. Levosimendan in cardiac failure after subarachnoid hemorrhage. J Trauma. 2010;68:E108–10.CrossRef Busani S, Rinaldi L, Severino C, et al. Levosimendan in cardiac failure after subarachnoid hemorrhage. J Trauma. 2010;68:E108–10.CrossRef
Metadata
Title
Reversible stress cardiomyopathy in Guillain-Barré syndrome: a case report
Authors
A. Gravos
A. Destounis
K. Katsifa
P. Tselioti
K. Sakellaridis
V. Grammatikopoulou
C. Tsapas
A. Nodarou
P. Batiani
A. Prekates
Publication date
01-12-2019
Publisher
BioMed Central
Published in
Journal of Medical Case Reports / Issue 1/2019
Electronic ISSN: 1752-1947
DOI
https://doi.org/10.1186/s13256-019-2085-9

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