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Seizure Associated Takotsubo Syndrome: A Rare Combination

Takotsubo cardiomyopathy (TC) is increasingly recognized in neurocritical care population especially in postmenopausal females. We are presenting a 61-year-old African American female with past medical history of epilepsy, bipolar disorder, and hypertension who presented with multiple episodes of se...

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Autores principales: Kyi, Htay Htay, Aljariri Alhesan, Nour, Upadhaya, Sunil, Al Hadidi, Samer
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Hindawi 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5546119/
https://www.ncbi.nlm.nih.gov/pubmed/28811941
http://dx.doi.org/10.1155/2017/8458054
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author Kyi, Htay Htay
Aljariri Alhesan, Nour
Upadhaya, Sunil
Al Hadidi, Samer
author_facet Kyi, Htay Htay
Aljariri Alhesan, Nour
Upadhaya, Sunil
Al Hadidi, Samer
author_sort Kyi, Htay Htay
collection PubMed
description Takotsubo cardiomyopathy (TC) is increasingly recognized in neurocritical care population especially in postmenopausal females. We are presenting a 61-year-old African American female with past medical history of epilepsy, bipolar disorder, and hypertension who presented with multiple episodes of seizures due to noncompliance with antiepileptic medications. She was on telemetry which showed ST alarm. Electrocardiogram (ECG) was ordered and showed ST elevation in anterolateral leads and troponins were positive. Subsequently Takotsubo cardiomyopathy was diagnosed by left ventriculography findings and absence of angiographic evidence of obstructive coronary artery disease. Echocardiogram showed apical hypokinesia, ejection fraction of 40%, and systolic anterior motion of mitral valve with hyperdynamic left ventricle, in the absence of intracoronary thrombus formation in the angiogram. Electroencephalography showed evidence of generalized tonic-clonic seizure. She was treated with supportive therapy. This case illustrates importance of ECG in all patients with seizure irrespective of cardiac symptoms as TC could be the cause of Sudden Unexpected Death in Epilepsy (SUDEP) and may be underdiagnosed and so undertreated.
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spelling pubmed-55461192017-08-15 Seizure Associated Takotsubo Syndrome: A Rare Combination Kyi, Htay Htay Aljariri Alhesan, Nour Upadhaya, Sunil Al Hadidi, Samer Case Rep Cardiol Case Report Takotsubo cardiomyopathy (TC) is increasingly recognized in neurocritical care population especially in postmenopausal females. We are presenting a 61-year-old African American female with past medical history of epilepsy, bipolar disorder, and hypertension who presented with multiple episodes of seizures due to noncompliance with antiepileptic medications. She was on telemetry which showed ST alarm. Electrocardiogram (ECG) was ordered and showed ST elevation in anterolateral leads and troponins were positive. Subsequently Takotsubo cardiomyopathy was diagnosed by left ventriculography findings and absence of angiographic evidence of obstructive coronary artery disease. Echocardiogram showed apical hypokinesia, ejection fraction of 40%, and systolic anterior motion of mitral valve with hyperdynamic left ventricle, in the absence of intracoronary thrombus formation in the angiogram. Electroencephalography showed evidence of generalized tonic-clonic seizure. She was treated with supportive therapy. This case illustrates importance of ECG in all patients with seizure irrespective of cardiac symptoms as TC could be the cause of Sudden Unexpected Death in Epilepsy (SUDEP) and may be underdiagnosed and so undertreated. Hindawi 2017 2017-07-24 /pmc/articles/PMC5546119/ /pubmed/28811941 http://dx.doi.org/10.1155/2017/8458054 Text en Copyright © 2017 Htay Htay Kyi et al. https://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Case Report
Kyi, Htay Htay
Aljariri Alhesan, Nour
Upadhaya, Sunil
Al Hadidi, Samer
Seizure Associated Takotsubo Syndrome: A Rare Combination
title Seizure Associated Takotsubo Syndrome: A Rare Combination
title_full Seizure Associated Takotsubo Syndrome: A Rare Combination
title_fullStr Seizure Associated Takotsubo Syndrome: A Rare Combination
title_full_unstemmed Seizure Associated Takotsubo Syndrome: A Rare Combination
title_short Seizure Associated Takotsubo Syndrome: A Rare Combination
title_sort seizure associated takotsubo syndrome: a rare combination
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5546119/
https://www.ncbi.nlm.nih.gov/pubmed/28811941
http://dx.doi.org/10.1155/2017/8458054
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