Title : Takotsubo syndrome as a rare complication in a young patient with pulmonary tuberculosis: Case report
Abstract:
Takotsubo syndrome, also known as broken heart syndrome, is characterized by transient left ventricular dysfunction. Previous clinical conditions, such as Mycobacterium tuberculosis infection, can act as precipitating factors. It is a rare condition, more common in white women with a mean age of 60 years, with only 3% of cases occurring in women under 50 years of age. A 24-year-old female patient, brown-skinned, was admitted to an infectious disease hospital with a diagnosis of pulmonary tuberculosis undergoing irregular treatment, presenting with anemia, chest pain, dyspnea, pallor, hypotension, and tachycardia. On the second day of hospitalization, she developed acute respiratory failure and septic shock of pulmonary origin. On the fourth day, she experienced cardiac arrest in ventricular fibrillation, with return to spontaneous circulation after two cycles of cardiopulmonary resuscitation and defibrillation. Transthoracic echocardiogram showed akinesia of the entire apical region of the left ventricle, diffuse hypokinesia of the other walls, moderate global contractile dysfunction, hypokinesia of the right ventricular septal wall, moderate mitral regurgitation, and ejection fraction of 43.21% (reference value ≥ 55%), changes suggestive of Takotsubo cardiomyopathy. Subsequent tests showed improvement in ventricular function. Despite recovery from ventricular dysfunction, she had an unfavorable clinical course, with progressive therapeutic failure, and palliative care was instituted. She died after 73 days of hospitalization. Although Takotsubo syndrome has gained prominence in cardiological investigations, its pathophysiology, management, and clinical outcome are still poorly understood.
