A left humerus fracture-induced Takotsubo syndrome

Submitted: 8 May 2024
Accepted: 24 July 2024
Published: 29 July 2024
Abstract Views: 323
PDF: 128
Publisher's note
All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.

Authors

Takotsubo syndrome (TS) is a transient cardiac condition characterized by regional systolic dysfunction, often precipitated by emotional or physical stressors. The pathophysiology of TS is not fully understood, but evidence suggests that it may be influenced by multiple factors. We present a case of TS following a traumatic left humerus fracture in an 82-year-old male patient with hypertension. Diagnosis was confirmed through comprehensive clinical evaluation, identification of ECG abnormalities, echocardiographic findings, and exclusion of other diseases. The patient’s management consisted of β-blockers, aspirin, and supportive care. Despite initial concerns, the patient's clinical course was uneventful, illustrating the various presentations of TS. This case emphasizes that TS can occur as a result of a traumatic event, particularly among older individuals with comorbidities. Early recognition and appropriate management are essential for optimizing outcomes.

Dimensions

Altmetric

PlumX Metrics

Downloads

Download data is not yet available.

Citations

Arbelo E, Protonotarios A, Gimeno JR, et al. 2023 ESC Guidelines for the management of cardiomyopathies: Developed by the task force on the management of cardiomyopathies of the European Society of Cardiology (ESC). Eur Heart J 2023;44:3503–626. DOI: https://doi.org/10.1093/eurheartj/ehad194
Lyon AR, Bossone E, Schneider B, et al. Current state of knowledge on Takotsubo syndrome: A Position Statement from the Taskforce on Takotsubo Syndrome of the Heart Failure Association of the European Society of Cardiology. Eur J Heart Fail 2016;18:8–27. DOI: https://doi.org/10.1002/ejhf.424
Ghadri JR, 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. DOI: https://doi.org/10.1093/eurheartj/ehy076
Fernandez CA, Narveson JR, Walters RW, et al. Takotsubo Cardiomyopathy and Trauma: The Role of Injuries as Physical Stressors. Cureus 2022;14:e27411. DOI: https://doi.org/10.7759/cureus.27411
Madhavan M, Prasad A. Proposed Mayo Clinic criteria for the diagnosis of Tako-Tsubo cardiomyopathy and long-term prognosis. Herz 2010;35:240–4. DOI: https://doi.org/10.1007/s00059-010-3339-x
Amin HZ, Amin LZ, Pradipta A. Takotsubo cardiomyopathy: a brief review. J Med Life 2020;13:3–7. DOI: https://doi.org/10.25122/jml-2018-0067
Scally C, Choo WK, Rudd A, et al. The early dynamic of ECG in Takotsubo syndrome presenting with ST-elevation: A comparison with age and gender-matched ST-elevation myocardial infarction. Int J Cardiol 2020;320:7–11. DOI: https://doi.org/10.1016/j.ijcard.2020.07.025
Choi SH, Lee OH, Yoon GS, et al. The relationship between J wave and ventricular tachycardia during Takotsubo cardiomyopathy. Internat J Arrhythmia 2020;21:1–8. DOI: https://doi.org/10.1186/s42444-020-00016-6
Højagergaard MA, Hassager C, Christensen TE, et al. Biomarkers in patients with Takotsubo cardiomyopathy compared to patients with acute anterior ST-elevation myocardial infarction. Biomarkers [Internet] 2020;25:137–43. DOI: https://doi.org/10.1080/1354750X.2019.1710767
Singh T, Khan H, Gamble DT, et al. Takotsubo syndrome: pathophysiology, emerging concepts, and clinical implications. Circulation 2022;145:1002-19. DOI: https://doi.org/10.1161/CIRCULATIONAHA.121.055854
Patel V, Levy S, Malik I, et al. Takotsubo cardiomyopathy in elderly female trauma patients: a case series. J Med Case Rep 2021;15:451. DOI: https://doi.org/10.1186/s13256-021-03056-1
Arcari L, Núñez Gil IJ, Stiermaier T, et al. Gender differences in Takotsubo syndrome. J Am Coll Cardiol 2022;79:2085–93. DOI: https://doi.org/10.1016/j.jacc.2022.03.366
Kosuge M, Ebina T, Hibi K, et al. Simple and accurate electrocardiographic criteria to differentiate takotsubo cardiomyopathy from anterior acute myocardial infarction. J Am Coll Cardiol 2010;55:2514–6. DOI: https://doi.org/10.1016/j.jacc.2009.12.059
Frangieh AH, Obeid S, Ghadri JR, et al. ECG criteria to differentiate between Takotsubo (stress) cardiomyopathy and myocardial infarction. J Am Heart Assoc 2016;5:e003418. DOI: https://doi.org/10.1161/JAHA.116.003418
Matta AG, Carrié D. Epidemiology, pathophysiology, diagnosis, and principles of management of Takotsubo cardiomyopathy: A Review. Med Sci Monit 2023;29:e939020. DOI: https://doi.org/10.12659/MSM.939020
Ghadri JR, Kato K, Cammann VL, et al. Long-term prognosis of patients with Takotsubo syndrome. J Am Coll Cardiol 2018;72:874–82. DOI: https://doi.org/10.1016/j.jacc.2018.06.016
Ahmed Y, Rafique M, Ahmad S, et al. Reverse Takotsubo cardiomyopathy in a patient with commotio cordis. J Med Cases 2022;13:414. DOI: https://doi.org/10.14740/jmc3951
Maréchaux S, Goldstein P, Girardie P, Ennezat PV. Contractile pattern of inverted Takotsubo cardiomyopathy: illustration by two-dimensional strain. Eur J Echocardiogr 2009;10:332–3. DOI: https://doi.org/10.1093/ejechocard/jen250
Mrozek S, Srairi M, Marhar F, et al. Successful treatment of inverted Takotsubo cardiomyopathy after severe traumatic brain injury with milrinone after dobutamine failure. Heart Lung 2016;45:406–8. DOI: https://doi.org/10.1016/j.hrtlng.2016.06.007
Riera M, Llompart-Pou JA, Carrillo A, Blanco C. Head injury and inverted Takotsubo cardiomyopathy. J Trauma 2010;68:E13–5. DOI: https://doi.org/10.1097/TA.0b013e3181469d5b

How to Cite

Rapino, A., Ceccuzzi, G., Perna, B., Maroncelli, G., Spampinato, M. D., Farina, G., De Giorgio, R., & Guarino, M. (2024). A left humerus fracture-induced Takotsubo syndrome. Emergency Care Journal, 20(3). https://doi.org/10.4081/ecj.2024.12647