Stroke and Takotsubo syndrome: a reciprocal relationship

• Published in: Revista de neurologiá Vol. 55; no. 8; pp. 475 - 478
• Main Authors: Mayor-Gómez, Sergio, Erro, María Elena, Olaz-Preciado, Fernando, Ciriza-Esandi, Mercedes, Gállego-Culleré, Jaime
• Format: Journal Article
• Language: Spanish
• Published: Spain 16.10.2012
• Subjects: Aged; Aged, 80 and over; Atrial Fibrillation - complications; Causality; Cerebral Angiography; Cerebral Cortex - blood supply; Cerebral Infarction - complications; Cerebral Infarction - diagnostic imaging; Diabetes Mellitus, Type 2 - complications; Dysarthria - etiology; Dyslipidemias - complications; Electrocardiography; Female; Humans; Hypertension - complications; Infarction, Posterior Cerebral Artery - diagnostic imaging; Infarction, Posterior Cerebral Artery - etiology; Magnetic Resonance Imaging; Paresis - etiology; Takotsubo Cardiomyopathy - complications; Takotsubo Cardiomyopathy - diagnosis; Takotsubo Cardiomyopathy - diagnostic imaging; Takotsubo Cardiomyopathy - pathology; Ultrasonography
• ISSN: 1576-6578
• DOI: 10.33588/rn.5508.2012328

Takotsubo syndrome is a transient stress cardiomyopathy associated with a distinctive left ventricular contraction pattern. It has been described as a cardioembolic source or as a consequence of stroke. Two patients are reported that illustrate the reciprocal relationship between Takotsubo syndrome and stroke and the physiopathological mechanisms implicated are analyzed. Two women aged 70 and 78 years respectively are described. The first one was admitted with electro-cardiogram ST-segment elevation, slight troponin elevation and stroke symptoms. Ecocardiography and cardiac magnetic resonance findings were consistent with Takotsubo syndrome that was the probable source of cardioembolic stroke. The second patient suffered a Takotsubo syndrome 72 hours after a brain infarction involving the insular cortex that was considered the trigger of Takotsubo syndrome. Takotsubo syndrome and stroke may have a reciprocal etiological relationship that is suggested by the temporal profile between the two processes. Cardiac magnetic resonance may aid in the establishment of the diagnosis of Takotsubo syndrome.