Takotsubo syndrome (TTS) is a rare disease mimicking acute coronary syndrome, often triggered by physical or emotional stress, and characterized by transient left ventricular dysfunction. Recurrences are described in about 5% of cases and may have different clinical and imaging patterns. In the present report, SARS-COV-2 infection, even in the absence of symptoms and overt emotional stress, seems correlated with recurrence of TTS, due to the absence of other recognized triggers. The hypothesis is that in predisposed patients, events like catecholamine-induced myocyte injury, direct viral damage, cytokine storm, immune-mediated damage, and procoagulant state, all possibly induced by the infection, may elicit endothelial dysfunction as substrate for TTS onset.

UNASSIGNED: First described in 1990 in Japan, Stress cardiomyopathy (SC) is characterized by transient systolic and diastolic left ventricular (LV) dysfunction with a variety of wall-motion abnormalities. It predominantly affects postmenopausal women and is often preceded by an emotional or physical trigger. SC is an increasingly recognized form of transient LV dysfunction that is often completely reversible.
METHODS: We report a case of SC induced by thyroidectomy in a postmenopausal woman with a good outcome for the patient.
UNASSIGNED: The pathogenesis of SC remains obscure, several possible hypotheses include catecholamine induced myocardial spasm or catecholamine related myocardial stunning, metabolic disorders and coronary microvascular damage. It is described as a disease with a 6-fold female-male predominance, affecting elderly postmenopausal women leading researchers to an estrogen-based theory for the pathogenesis. Thera are also increasing evidences for link between SC and thyroid pathology. There is no consensus on the diagnostic criteria for SC.
CONCLUSIONS: SC should be kept in mind especially in women with postmenopausal syndrome in perioperative period.

UNASSIGNED: Stress cardiomyopathy (Takotsubo syndrome) defined as Takotsubo syndrome is defined as a reversible acute myocardial syndrome with myocardial injury with regional wall motion abnormality and no coronary explanations in the context of stress. The pathophysiology remains partially unknown, and these cases are probably underestimated in paediatrics. We report six cases of Takotsubo probably secondary to neurological damage.
UNASSIGNED: Six patients (10, 13, 16, 10, and 9 years and 5 months) presented with haemodynamic lability with echocardiography data leading to suspicion of Takotsubo syndrome. These cases were secondary to neurological involvement (cerebral haemorrhage, intraventricular haemorrhage, brain damage due to bifrontal oedema, posterior fossa tumour, pneumococcal meningitis, high-grade glioma). All patients were rapidly started on amine. Reversibility of the acute myocardial syndrome was complete in all but one child, who rapidly progressed to encephalic death.
UNASSIGNED: Neurological distress has been suggested as a potential cause of Takotsubo syndrome. The pathophysiology is possibly related to excessive stimulation of the sympathetic system. This syndrome should probably be considered in the setting of left heart failure with neurological distress so as not to delay the use of amines especially since in the paediatric population the probability of a coronary origin is low.

We present the case of a 32-year-old woman with a diagnosis of lumbar root syndrome and spondylolisthesis, which is why she underwent surgery. Anterior discectomy and intersomatic box placement plus posterior fixation were performed with percutaneous transpedicular screws in L5-S1. At 24 hours of the procedure, the patient presents sustained hypotension, adding sudden and intense chest pain with neck irradiation, dyspnea, and diaphoresis, as well as electrocardiographic abnormalities and elevation of cardiac enzymes suggestive of an acute coronary syndrome, subsequently evidence of basal hypokinesis in the echocardiogram. After providing hemodynamic support and analgesic management, the symptoms were resolved, and the electrocardiogram (ECG) and cardiac enzymes were normalized, allowing an adequate postoperative evolution.

Stress-induced cardiomyopathy, commonly known as Takotsubo cardiomyopathy (TCM), is a clinical syndrome characterized by acute and transient ventricular systolic dysfunction that often presents with chest pain and may resemble an acute coronary syndrome. This case report discusses a complex clinical scenario involving an adult female with severe depression who attempted suicide through drug overdose, subsequently developing serotonin syndrome. Her clinical presentation was further complicated by the emergence of a unique lambda-shaped triangular QRS-ST-T waveform fusion ST-elevation electrocardiographic (ECG) pattern closely mimicking an anterolateral occlusive myocardial infarction. The study delves into the clinical implications of this unique ECG pattern in TCM, providing valuable insights into diagnosing and treating such complex cases. This case underscores the importance of recognizing diverse manifestations of TCM and its potential for severe cardiovascular complications.

Stress cardiomyopathy is a transient left ventricular dysfunction caused by physiologic or pathologic stressors. Anaphylaxis is a hypersensitivity disorder that can lead to a rapid life-threatening respiratory collapse. It happens due to exposure to allergens including medications. During anaphylaxis, there is a compensatory release of catecholamines that can lead to stress cardiomyopathy. In this case, nab-paclitaxel infusion led to anaphylaxis with respiratory failure. Echocardiogram showed features of diffuse hypokinesis with preserved basal segment contractility, and cardiac catheterization did not show any evidence of obstructive coronary artery disease. The overall clinical picture suggested stress cardiomyopathy. The patient was treated with guideline-directed medical therapy which resulted in normalization of the ejection fraction with no symptoms of congestive heart failure at any point. The patient was thereafter resumed on a reduced dose of nab-paclitaxel. This case report adds to the spectrum of infusion-related reactions associated with paclitaxel and demonstrates the course of events in the management of anaphylaxis and stress cardiomyopathy in this scenario.

Stress cardiomyopathy (Takotsubo syndrome) is a rare and transient cardiac dysfunction that has been reported in pregnant women with multiple triggering conditions. In general, those cases recovered from the acute cardiac insult within a few weeks. We report a 33-year-old 22 weeks pregnant woman, who presented with an episode of status epilepticus and subsequently developed acute heart failure. She had full recovery within three weeks and continued her pregnancy till term. She became pregnant again two years after this initial insult, remained asymptomatic with stable cardiac function and had normal vaginal delivery at term.

Takotsubo cardiomyopathy and acute coronary syndrome are often clinically indistinguishable, making their differentiation challenging for physicians. We present a case of a 65-year-old female who presented with acute chest pain, shortness of breath, and a recent psychosocial stressor. This is a unique case in which our patient, with known history of coronary artery disease and recent percutaneous intervention, favored a misleading initial diagnosis of non-ST elevation myocardial infarction.

Takotsubo, or stress cardiomyopathy (SC), is described as a transient systolic dysfunction of the apical segments of the left ventricle mainly triggered by emotional or physical stress resembling the presentation of an acute coronary syndrome in the absence of obstructive coronary artery disease. Reverse Takotsubo SC is a rare variant of SC that presents with basal ballooning instead of apical ballooning seen in classic SC. We present a case of a 74-year-old male who was admitted to the ICU with septic shock. Laboratory test results showed elevated troponin. An echocardiogram showed reduced cardiac contractility and relative hypokinesis of the basal and mid segments compared to the apical segments, consistent with reverse Takotsubo SC, which recovered after 10 days. It can happen in critically ill patients in the ICU secondary to severe sepsis and could contribute to hemodynamic worsening, affecting the final clinical outcomes.

Acute ST-segment elevation myocardial infarction (STEMI) can typically complicate with the development of cardiogenic shock; nevertheless, other less frequent types of shock may occur, including adrenal crisis (AC). We describe a case of STEMI complicated by AC and, for the first time, AC-induced focal takotsubo syndrome.