Takotsubo cardiomyopathy associated with pulmonary tuberculosis

Abstract

Takotsubo cardiomyopathy (CMP) is a temporary, sometimes dramatic regional left ventricular dysfunction, accompanied by clinical, laboratory and ECG data of acute coronary syndrome (ACS), in absence of obstructive coronary artery disease. The term “Takotsubo” was first used in Japan in 1990 by Sato (1). The name of the disease is associated with the characteristic apical ballooning of the left ventricle in systole and its resemblance to the popular in Asia: octopus trap (takotsubo). The disease is also known as stress-induced cardiomyopathy, "broken heart syndrome" or "apical ballooning syndrome". The triggers are "stress", which can be physical or emotional, non-cardiac surgery, severe illness, cocaine use and others, but the main pathophysiological role is played by endogenous catecholamine overstimulation.

A number of cases of stress-induced cardiomyopathy, triggered by the above factors have been described in the medical literature, but there was only one case of Takotsubo cardiomyopathy, associated with pulmonary tuberculosis (2). In the present clinical case, we present a middle-aged man with established active pulmonary tuberculosis, admitted to the clinic with clinical and electrocardiographic (ECG) data for acute coronary syndrome with ST elevations of the posterior and anterior wall of the left ventricle, which was rejected after performing selective coronary angiography (SCAG).