A Case of Recurrent Takotsubo Cardiomyopathy

      The patient is a postmenopausal female in her mid-50s with a reported history of Crohn's disease who presented on 3 separate occasions with gastrointestinal symptoms that progressed to chest pain with elevated troponin and wall motion abnormalities on transthoracic echocardiogram. High-sensitivity troponin peak, leukocyte count, inflammatory markers, and echocardiographic description for each episode are presented in the Figure. During the first episode, she additionally developed respiratory failure. The transthoracic echocardiogram demonstrated a left ventricular ejection fraction of 20% with apical hypokinesis and basal sparing, consistent with classic takotsubo cardiomyopathy. She underwent urgent coronary angiography showing no occlusive disease or plaque rupture. She was started on lisinopril for heart failure. At follow-up, echocardiogram demonstrated normal left ventricular ejection fraction and wall motion, and her heart failure medications were discontinued.
      FigureTabular summary of patient episodes.
      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'


      Subscribe to The American Journal of Medicine
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect


        • Ghadri J-R
        • Wittstein IS
        • Prasad A
        • et al.
        International expert consensus document on takotsubo syndrome (Part I): clinical characteristics, diagnostic criteria, and pathophysiology.
        Eur Heart J. 2018; 39: 2032-2046
        • Templin C
        • Ghadri JR
        • Diekmann J
        • et al.
        Clinical features and outcomes of takotsubo (stress) cardiomyopathy.
        N Engl J Med. 2015; 373: 929-938
        • Scantlebury DC
        • Prasad A
        Diagnosis of takotsubo cardiomyopathy.
        Circ J. 2014; 78: 2129-2139
        • Ghadri J-R
        • Wittstein IS
        • Prasad A
        • et al.
        International expert consensus document on Takotsubo syndrome (Part II): diagnostic workup, outcome, and management.
        Eur Heart J. 2018; 39: 2047-2062
        • Wittstein IS
        • Thiemann DR
        • Lima JAC
        • et al.
        Neurohumoral features of myocardial stunning due to sudden emotional stress.
        N Engl J Med. 2005; 352: 539-548