Atypical Clinical Presentation of Takotsubo Syndrome in Association with Unusual Clinical onset of Myasthenia Gravis: a Case Report
Year: 2024
Type: article
Study design: Case Report
Abstract: Introduction: Takotsubo syndrome (TTS) is a cardiomyopathy triggered by emotional or physical stress. This case report presents a unique instance of TTS associated with myasthenia gravis (MG) in which myasthenic crisis developed after TTS diagnosis and not before. Case Description: A 73-year-old man presented with difficulty swallowing, dysphonia, and dyspnea, showing moderate-severe left ventricular dysfunction. Blood tests revealed elevated troponin and BNP levels, while the ECG at the arrival showed an ST-elevation in anterior leads. Coronary angiography showed normal aspect of coronary vessels. Echocardiography confirmed TTS with apical ballooning. After few days, myasthenic symptoms emerged leading to a myasthenic crisis. The patient improved with acetylcholinesterase inhibitors and was discharged with pyridostigmine and prednisone. Follow-up revealed complete resolution of left ventricular dysfunction. Discussion: MG rarely affects the heart, but in this case, it led to TTS. Notably, TTS occurred before the myasthenic crisis, emphasizing the need for cardiac monitoring in patients with new neurological diagnoses and acute respiratory.
Author: Gianluca Guarnieri
Institutions: University of Milan, Centro Cardiologico Monzino
Language: English
Subfield: Cardiology and Cardiovascular Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: hybrid
OpenAlex ID: W4406291691