Myasthenic Crisis and Concomitant Takotsubo Syndrome Complicated by Shock: A Case Report

Intern Med. 2024 May 9. doi: 10.2169/internalmedicine.3306-23. Online ahead of print.


A man in his 80s with myasthenia gravis (MG) developed dysmobility and chest discomfort. An electrocardiogram revealed ST-segment elevation, and coronary angiography revealed Takotsubo syndrome (TTS). He experienced myasthenic crisis that required ventilation and shock that was refractory to vasopressors and required intra-aortic balloon pump (IABP) insertion. He was managed conservatively without MG-specific treatment until his hemodynamics improved. On hospital day 6, he was weaned from IABP. MG is a high-risk condition for TTS, and TTS with MC is associated with high mortality. We successfully managed this case of TTS with MC with intubation and IABP, without MG-specific treatment.

Keywords: Myasthenia gravis; myasthenic crisis; takotsubo syndrome.