Posters
Academic Level (Author 1)
Resident
Discipline/Specialty (Author 1)
Internal Medicine
Academic Level (Author 2)
Resident
Discipline/Specialty (Author 2)
Internal Medicine
Academic Level (Author 3)
Resident
Discipline/Specialty (Author 3)
Internal Medicine
Academic Level (Author 4)
Resident
Discipline/Specialty (Author 4)
Internal Medicine
Discipline Track
Clinical Science
Abstract
Background: Takatsubo (tako- octopus, tsubo- a pot) Cardiomyopathy (TTS) colloquially known as broken heart syndrome is a left or right (in 1/3rd patients) ventricular motion abnormality that extends even beyond the coronary artery supply areas, with non-obstructive coronaries. Most commonly due to emotional or physical stressors and in some cases in hospitalized patients (2). The Coronavirus-19 (COVID-19) pandemic has resulted in a total death toll of 1.1 million in the United States of America so far, with cardiovascular complications such as heart failure (7.7%) and ischemic heart disease (10.9%) being significant contributors(1). TTS prevalence in the general population is 2.2%, mostly in women (3), literature search between 2020 and 2022 in pubmed has revealed at least 69 case reports of TTS in COVID-19 patients. A large cohort study at Cleveland Clinic showed incidence of Takatsubo Cardiomyopathy in 7.75% of patients with COVID-19 (4). Our report is of a Hispanic female patient with COVID-19 diagnosed with Takatsubo Cardiomyopathy.
Case presentation: 83-year-old Hispanic female with a history of dementia and coronary artery disease on Plavix and aspirin was brought to the Emergency room after an episode of ground level fall and confusion, history was also significant for a week history of shortness of breath with non-productive cough. Examination findings were unremarkable. Initial laboratory findings were significant for a positive nasopharyngeal COVID-19 PCR test. On further evaluation it was noted that the patient had an ST elevation on the lateral leads and an elevated high sensitivity troponin (hs-cTn) of 0.32. Patient was immediately taken to the Cath-lab for a left and right coronary angiography which showed non-obstructive coronary artery disease and a left ventricular ejection fraction of 40-45%. A diagnosis of Takatsubo cardiomyopathy was made. Patient was started on Aspirin, ACE/ARB, Betablockers, high intensity statin.
Conclusion: We know COVID-19 warrants anticoagulation due to its hypercoagulable state. With the current prevalence of TTS in COVID-19, it would be worthwhile to assess whether elderly patients with an acute coronary syndrome presentation could benefit from non-invasive investigations and medical management rather than undergoing an invasive coronary catheterization.
Presentation Type
Poster
Recommended Citation
Thomas, Percy M.; Rivera, Jose; Rodriguez-Paez, Josenny; and Ganguly, Arup, "Takatsubo Cardiomyopathy in a Hispanic female with COVID-19 infection." (2024). Research Colloquium. 28.
https://scholarworks.utrgv.edu/colloquium/2023/posters/28
Included in
Takatsubo Cardiomyopathy in a Hispanic female with COVID-19 infection.
Background: Takatsubo (tako- octopus, tsubo- a pot) Cardiomyopathy (TTS) colloquially known as broken heart syndrome is a left or right (in 1/3rd patients) ventricular motion abnormality that extends even beyond the coronary artery supply areas, with non-obstructive coronaries. Most commonly due to emotional or physical stressors and in some cases in hospitalized patients (2). The Coronavirus-19 (COVID-19) pandemic has resulted in a total death toll of 1.1 million in the United States of America so far, with cardiovascular complications such as heart failure (7.7%) and ischemic heart disease (10.9%) being significant contributors(1). TTS prevalence in the general population is 2.2%, mostly in women (3), literature search between 2020 and 2022 in pubmed has revealed at least 69 case reports of TTS in COVID-19 patients. A large cohort study at Cleveland Clinic showed incidence of Takatsubo Cardiomyopathy in 7.75% of patients with COVID-19 (4). Our report is of a Hispanic female patient with COVID-19 diagnosed with Takatsubo Cardiomyopathy.
Case presentation: 83-year-old Hispanic female with a history of dementia and coronary artery disease on Plavix and aspirin was brought to the Emergency room after an episode of ground level fall and confusion, history was also significant for a week history of shortness of breath with non-productive cough. Examination findings were unremarkable. Initial laboratory findings were significant for a positive nasopharyngeal COVID-19 PCR test. On further evaluation it was noted that the patient had an ST elevation on the lateral leads and an elevated high sensitivity troponin (hs-cTn) of 0.32. Patient was immediately taken to the Cath-lab for a left and right coronary angiography which showed non-obstructive coronary artery disease and a left ventricular ejection fraction of 40-45%. A diagnosis of Takatsubo cardiomyopathy was made. Patient was started on Aspirin, ACE/ARB, Betablockers, high intensity statin.
Conclusion: We know COVID-19 warrants anticoagulation due to its hypercoagulable state. With the current prevalence of TTS in COVID-19, it would be worthwhile to assess whether elderly patients with an acute coronary syndrome presentation could benefit from non-invasive investigations and medical management rather than undergoing an invasive coronary catheterization.