Cardioversion-Induced Takotsubo Cardiomyopathy

TL;DR

A 77-year-old woman developed takotsubo cardiomyopathy after a cardioversion procedure for atrial fibrillation, but her heart function improved after treatment.

Contribution

This case report highlights a rare instance of takotsubo cardiomyopathy triggered by cardioversion rather than typical stressors.

Findings

The patient developed takotsubo cardiomyopathy four days after cardioversion.

Her symptoms resolved within three days with IV diuretic treatment.

Echocardiogram showed significant improvement in cardiac function before discharge.

Abstract

Takotsubo cardiomyopathy, also known as stress-induced cardiomyopathy or "broken heart syndrome," is a rare and reversible condition characterized by transient left ventricular dysfunction. It is typically triggered by acute emotional or physical stressors. Here, we present a unique case of TCM occurring in a 77-year-old woman following cardioversion for persistent and symptomatic atrial fibrillation. The patient underwent uncomplicated cardioversion with recent imaging showing intact global systolic function. She presented four days post-procedure for chest pain, shortness of breath, and peripheral edema. A repeat echocardiogram showed a marked decrease in cardiac function evidenced by an ejection fraction of 20-25%. The patient was readmitted and managed with IV diuretics. Symptoms resolved within three days and the patient showed improved cardiac function on imaging prior to discharge.

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