key: cord-1039356-5ogbwceo
authors: Mishra, Ajay Kumar; Dai, Qiying; Sahu, Kamal Kant; ElMeligy, Amr
title: Atypical Takotsubo cardiomyopathy in COVID-19
date: 2021-01-30
journal: Am J Med Sci
DOI: 10.1016/j.amjms.2021.01.024
sha: bbb49b23ab0a69ebd05337f6a56f045eec7c324a
doc_id: 1039356
cord_uid: 5ogbwceo

nan

A 70-year-old man with hypertension; hyperlipidemia, type 2 diabetes, chronic obstructive pulmonary disease, atrial fibrillation, status post cardioversion, and ablation, currently in sinus rhythm, presented to the hospital with insidious onset, gradually progressive shortness of breath, and a low-grade, intermittent fever of one-week duration. On the day of the presentation, he was in moderate respiratory distress. His Oxygen saturation was 85% on supplemental O2 at 6 l/min. Takotsubo cardiomyopathy (also known as broken heart syndrome, transient apical ballooning syndrome, and stress cardiomyopathy is a form of reversible cardiomyopathy. It mimics the clinical syndrome of acute myocardial infarction in the absence of coronary artery stenosis or spasm. It derives its name from the Japanese octopus fishing pot called 'takotsubo' to which the involved heart resembles in shape. This syndrome is most commonly seen in postmenopausal women in the presence of extreme physical or emotional stress. It is diagnosed with a typical finding of transient, reversible apical hypokinesia and associated basal hyperkinesia. Reverse Takotsubo cardiomyopathy is its variant characterized by reversible, basal akinesia/hypokinesis and associated apical hyperkinesia. 1 Patients with severe COVID-19 disease most commonly present with the involvement of the respiratory system. Cardiovascular involvement, including acute myocardial injury, stress induced cardiomyopathy, has also been commonly reported in 5% of these patients. 2 To date, 9 patients with stress-induced cardiomyopathy secondary to COVID-19 has been reported. 1, 3 We report the first male patient with reverse Takotsubo cardiomyopathy secondary to COVID-19 infection. The physiologic cause of this Broken Heart Syndrome could either have been the initial stress of acute lung injury from COVID-19 or subsequent deterioration secondary to cytokine storm.

Acute myocarditis presenting as a reverse Tako-Tsubo syndrome in a patient with SARS-CoV-2 respiratory infection

A review of cardiac manifestations and predictors of outcome in patients with COVID -19