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Case Reports
. 2020 Dec;7(6):4297-4300.
doi: 10.1002/ehf2.12912. Epub 2020 Sep 4.

Takotsubo syndrome as a complication in a critically ill COVID-19 patient

Maurizio Bottiroli  1 , Daniele De Caria  1 , Oriana Belli  2 , Angelo Calini  1 , Patrizia Andreoni  1 , Antonio Siragusa  1   3 , Antonella Moreo  2 , Enrico Ammirati  2 , Michele Mondino  1 , Roberto Fumagalli  1   3
Affiliations
Case Reports

Takotsubo syndrome as a complication in a critically ill COVID-19 patient

Maurizio Bottiroli et al. ESC Heart Fail. 2020 Dec.

Abstract

Coronavirus disease 2019 (COVID-19) patients with cardiac injury have an increased risk of mortality. It remains to be determined the mechanism of cardiac injury and the identification of specific conditions that affect the heart during COVID-19. We present the case of a 76-year-old woman with COVID-19 pneumonia that developed a takotsubo syndrome (TTS). Although the patient presented normal left ventricular ejection fraction and normal levels of troponin on admission, after 16 days in intensive care unit due to respiratory distress, she suddenly developed cardiogenic shock. Shock occurred few hours after a spontaneous breathing trial through her tracheostomy. Bed-side echocardiographic revealed apical ballooning promptly supporting the diagnosis of TTS. She was successfully treated with deep sedation and low dosage of epinephrine. The relevance of this case is that TTS can occur in the late phase of COVID-19. Awareness of late TTS and bed-side echocardiographic evaluation can lead to prompt identification and treatment.

Keywords: Cardiac injury; Coronavirus disease 2019; Severe acute respiratory syndrome coronavirus 2; Takotsubo syndrome.

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Conflict of interest statement

None declared.

Figures

FIGURE 1
FIGURE 1
(A) Chest X‐ray and (B) computed tomography of interstitial pneumonia. (C–E) Serial electrocardiograms before, during, and after takotsubo syndrome.
See this image and copyright information in PMC

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