Recurrent Takotsubo Cardiomyopathy Related to Recurrent Thyrotoxicosis

Tex Heart Inst J. 2016 Apr 1;43(2):152-5. doi: 10.14503/THIJ-15-5046. eCollection 2016 Apr.

Abstract

Takotsubo cardiomyopathy, or transient left ventricular apical ballooning syndrome, is characterized by acute left ventricular dysfunction caused by transient wall-motion abnormalities of the left ventricular apex and mid ventricle in the absence of obstructive coronary artery disease. Recurrent episodes are rare but have been reported, and several cases of takotsubo cardiomyopathy have been described in the presence of hyperthyroidism. We report the case of a 55-year-old woman who had recurrent takotsubo cardiomyopathy, documented by repeat coronary angiography and evaluations of left ventricular function, in the presence of recurrent hyperthyroidism related to Graves disease. After both episodes, the patient's left ventricular function returned to normal when her thyroid function normalized. These findings suggest a possible role of thyroid-hormone excess in the pathophysiology of some patients who have takotsubo cardiomyopathy.

Keywords: Hyperthyroidism/complications; takotsubo cardiomyopathy/diagnosis/physiopathology/therapy; thyroid diseases/physiopathology; thyroid function tests; thyrotoxicosis/complications; treatment outcome; ventricular dysfunction, left/diagnosis/etiology.

Publication types

  • Case Reports

MeSH terms

  • Coronary Angiography
  • Echocardiography
  • Electrocardiography
  • Female
  • Follow-Up Studies
  • Humans
  • Middle Aged
  • Recovery of Function
  • Takotsubo Cardiomyopathy / diagnosis
  • Takotsubo Cardiomyopathy / etiology*
  • Takotsubo Cardiomyopathy / physiopathology
  • Thyrotoxicosis / complications*
  • Thyrotoxicosis / diagnosis
  • Ventricular Function, Left / physiology*