Electrolyte Disorders as Triggers for Takotsubo Cardiomyopathy

A 56-year-old woman presented with cognitive impairment, confusion and slowed speech, muscle cramps and peripheral paraesthesia preceded by vomiting. Blood tests revealed severe hypokalaemia, hyponatremia, hypomagnesemia and hypocalcaemia. Following a diagnosis of Takotsubo cardiomyopathy based on ultrasonography, the patient was treated with electrolyte supplementation and recovered within 48h. When heart failure is suspected, electrolyte abnormalities should be carefully ruled out as they can affect cardiac function. LEARNING POINTS: The association between electrolyte abnormalities and Takotsubo cardiomyopathy has still not been well established in the literature. Hypomagnesemia and hypocalcaemia can contribute to cardiac akinesia and so should be ruled out in heart failure. Correction of hypomagnesemia and hypocalcaemia is an important and an under-estimated part of the optimal treatment of cardiac failure.