Cardiogenic shock due to Takotsubo cardiomyopathy associated with thyroid crisis: a case report

Abstract Background The development of cardiogenic shock due to the coexistence of Takotsubo cardiomyopathy and thyroid crisis in patients has been scarcely reported. Case summary A 46-year-old female presented with chest pain, palpitations, nausea, and vomiting for 8 h. She was initially considered...

Full description

Saved in:
Bibliographic Details
Published in:European heart journal : case reports 2022-10, Vol.6 (10)
Main Authors: Fan, Xiaojuan, Liu, Ping, Bai, Ling
Format: Article
Language:English
Subjects:
Atrial fibrillation
Cardiac patients
Cardiogenic shock
Cardiomyopathy
Case Report
Electrocardiogram
Electrocardiography
Heart
Heart diseases
Nausea
Palpitation
Thyroid diseases
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Abstract Background The development of cardiogenic shock due to the coexistence of Takotsubo cardiomyopathy and thyroid crisis in patients has been scarcely reported. Case summary A 46-year-old female presented with chest pain, palpitations, nausea, and vomiting for 8 h. She was initially considered to have acute myocardial infarction due to elevated cardiac markers and abnormal electrocardiogram changes. Immediately after the coronary angiography revealed a normal coronary artery, the patient developed refractory cardiogenic shock. Echocardiography demonstrated a typical apical ballooning type of Takotsubo cardiomyopathy with a left ventricular ejection fraction (LVEF) of 32%. A combination of norepinephrine and dopamine and an intra-aortic balloon pump (IABP) was used to support haemodynamic stability but failed to improve the patient’s condition. Immediately after the laboratory tests revealed previously unknown hyperthyroidism on the second hospital day, a rapid atrial fibrillation (AF) suddenly occurred. Nifekalant successfully restored sinus rhythm in a short time. The patient persistently complained of chest tightness, palpitations, and sweating for the first 4 days until levosimendan and antithyroid crisis treatment were used. Discussion Takotsubo cardiomyopathy and thyroid crisis can co-occur and present as cardiogenic shock. In the presence of severe cardiac dysfunction and untreated hyperthyroidism, nifekalant is an ideal option for the new onset of AF. The combination of heart failure treatment and antithyroid crisis drugs can effectively restore cardiac function and is associated with good clinical outcomes.
ISSN:2514-2119
2514-2119
DOI:10.1093/ehjcr/ytac381