Abstract
BackgroundTakotsubo cardiomyopathy is a non-ischemic cardiomyopathy characterized by acute left ventricular systolic dysfunction with transient wall motion abnormalities without a culprit coronary stenosis or other concurrent diagnoses. Its coexistence with transient high-degree AV block is very infrequent.Case presentationA 61-year-old man presented with a new onset of high degree AV block without ST segment deviations developing an anterior and apical dyskinesia with a low left ventricular ejection fraction in the absence of coronary artery disease.ConclusionAtrioventricular block is an uncommon presentation of Takotsubo syndrome. The management of patients with relevant conduction disorders in this scenario is a challenge for the clinician. In case of persistence of advanced conduction disorders, it seems appropriate to implant a pacemaker.
Highlights
Takotsubo cardiomyopathy is a non-ischemic cardiomyopathy characterized by acute left ventricular systolic dysfunction with transient wall motion abnormalities without a culprit coronary stenosis or other concurrent diagnoses
Takotsubo cardiomyopathy (TCM) is characterized by transient left ventricular dysfunction in the absence of coronary artery disease. It has a clinical presentation usually resembling an acute coronary syndrome, and patients will present with sudden acute chest pain or dyspnea and ST segment elevation or T wave inversion on the electrocardiogram
The electrocardiogram showed new onset of high-degree AV block
Summary
Takotsubo cardiomyopathy (TCM) is characterized by transient left ventricular dysfunction in the absence of coronary artery disease. It has a clinical presentation usually resembling an acute coronary syndrome, and patients will present with sudden acute chest pain or dyspnea and ST segment elevation or T wave inversion on the electrocardiogram. On initial evaluation at the emergency department, the patient was afebrile with an initial blood pressure of 90/50 mmHg and blood oxygen saturation level of 85%. He presented with bradycardia, and the electrocardiogram showed new onset of high-degree AV block. According to the INTERTAK criteria, TCM diagnosis was made [1, 2]
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