When Grief Strains the Heart: A Case of Reverse Takotsubo Cardiomyopathy Triggered by Mourning and Respiratory Failure.
Peter Cwalina, Ibrahim Rahmatullah, Ayesha Samad et al.
✦ AI-curated · Sources linked
Case in brief
A 69-year-old woman with a history of coronary artery disease and COPD presented with severe respiratory distress and unresponsiveness, requiring intubation. She tested positive for coronavirus OC43 and was treated in the ICU for respiratory failure. Cardiac evaluation revealed elevated troponin levels and echocardiography showed segmental wall motion abnormalities. Urgent angiography confirmed reverse takotsubo cardiomyopathy with basal hypokinesis and preserved apical contraction, linked to ongoing grief from her sister's death.
What made this case unusual
This case highlights reverse takotsubo cardiomyopathy triggered by acute respiratory failure rather than an immediate emotional stressor, which is atypical for this condition.
Diagnostic / clinical pearl
Clinicians should consider reverse takotsubo cardiomyopathy in patients presenting with ACS-like symptoms during acute illness, especially when emotional stressors are chronic.
Why it matters
Recognizing the unique presentation of reverse takotsubo can prevent misdiagnosis and ensure appropriate management in critically ill patients.