Seizure Associated Takotsubo Syndrome: A Rare Combination

Takotsubo cardiomyopathy (TC) is increasingly recognized in neurocritical care population especially in postmenopausal females. We are presenting a 61-year-old African American female with past medical history of epilepsy, bipolar disorder, and hypertension who presented with multiple episodes of se...

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Bibliographic Details
Published in:Case reports in cardiology 2017-01, Vol.2017 (2017), p.1-6
Main Authors: Al Hadidi, Samer, Upadhaya, Sunil, Aljariri Alhesan, Nour, Kyi, Htay Htay
Format: Article
Language:English
Subjects:
Acute coronary syndromes
Cardiac arrhythmia
Cardiology
Cardiomyopathy
Cardiovascular disease
Case Report
Case reports
Epilepsy
Heart failure
NMR
Nuclear magnetic resonance
Pain
Patients
Ultrasonic imaging
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Summary:Takotsubo cardiomyopathy (TC) is increasingly recognized in neurocritical care population especially in postmenopausal females. We are presenting a 61-year-old African American female with past medical history of epilepsy, bipolar disorder, and hypertension who presented with multiple episodes of seizures due to noncompliance with antiepileptic medications. She was on telemetry which showed ST alarm. Electrocardiogram (ECG) was ordered and showed ST elevation in anterolateral leads and troponins were positive. Subsequently Takotsubo cardiomyopathy was diagnosed by left ventriculography findings and absence of angiographic evidence of obstructive coronary artery disease. Echocardiogram showed apical hypokinesia, ejection fraction of 40%, and systolic anterior motion of mitral valve with hyperdynamic left ventricle, in the absence of intracoronary thrombus formation in the angiogram. Electroencephalography showed evidence of generalized tonic-clonic seizure. She was treated with supportive therapy. This case illustrates importance of ECG in all patients with seizure irrespective of cardiac symptoms as TC could be the cause of Sudden Unexpected Death in Epilepsy (SUDEP) and may be underdiagnosed and so undertreated.
ISSN:2090-6404
2090-6412
DOI:10.1155/2017/8458054