Gastroenterology Research, ISSN 1918-2805 print, 1918-2813 online, Open Access
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Case Report

Volume 16, Number 3, June 2023, pages 195-200

Takotsubo Cardiomyopathy Associated With Acute Pancreatitis

Figures

Figure 1.
Figure 1. ECG showing diffuse deep T wave inversions suggestive of ischemia (case 1). ECG: electrocardiography.
Figure 2.
Figure 2. Normal coronary angiogram of the patient consistent with Takotsubo cardiomyopathy (case 1).
Figure 3.
Figure 3. Four-chamber view of left ventricle in (a) diastole and (b) systole, showing hypercontractile basal segment (yellow arrow) with apical ballooning (orange arrow) consistent with Takotsubo cardiomyopathy (case 1).
Figure 4.
Figure 4. ECG showing diffuse T wave inversion suggestive of ischemia (case 2). ECG: electrocardiography.
Figure 5.
Figure 5. Four-chamber view of left ventricle in (a) diastole and (b) systole, showing hypercontractile basal segment (yellow arrow) with apical ballooning (orange arrow) consistent with Takotsubo cardiomyopathy (case 2).

Table

Table 1. Patients Reported in the Literature with Takotsubo Cardiomyopathy
 
AuthorsAge (years)SexEtiology of pancreatitisTime to TCMSymptoms of TCMTroponin (ng/mL; reference < 0.02)ECGEchocardiogram or ventriculographyRecovery of LVEF
F: female; M: male; ECG: electrocardiography; SOB: shortness of breath; PEA: pulseless electrical activity; TWI: T wave inversion; LVEF: left ventricular ejection fraction; EF: ejection fraction; LV: left ventricular; ERCP: endoscopic retrograde cholangiopancreatography; s/p: status post.
Sankri-Tarbichi et al, 2007 [6]56FGallstones3 daysSOB, chest pain, nausea2.39TWI V2-5LVEF 25%, severe apical hypokinesia/akinesia of left ventricle, hypercontractile baseYes
Rajani et al, 2010 [7]72F-7 daysChest pain0.32Inferolateral TWIApical akinesis-
Cheezum et al, 2010 [8]76FGallstones2 daysTachypnoea, hypoxemic0.67Lateral ST elevationLVEF 30%, severe apical hypokinesis + hyperdynamic basal contractionYes
Pednekar et al, 2010 [9]70F-Same dayCardiac arrest3.13Inferior ST elevation, anterior TWILVEF 30%Yes
Leubner et al, 2014 [10]76FGallstones1 daySOB, diaphoresis9.94Anteroseptal ST elevationLVEF 30-35%, hypokinetic apical left ventricle-
Bruenjes et al, 2015 [11]55MAlcoholSame dayChest pain, diaphoresis, nausea0.66Generalized ST depression + TWILVEF 25%, apical ballooning, hypercontractile basal segmentsYes
Boulos et al, 2015 [12]47F--Nausea0.3Inferolateral TWIAkinesis of distal anterior, lateral, and inferior walls of left ventricle-
Garbowska et al, 2016 [13]47FAlcohol7 daysChest pain, SOB9.65ST elevation V2LVEF 25%, apical ballooning, hypercontractile basal segments of left ventricleYes
Koop et al, 2018 [5]63MGallstones3 daysOliguria, hypotension, SOB, PEA arrest0.02Nonspecific inferolateral T-wave changesLVEF 20-25%, new-onset cardiomyopathy, global hypokinesisYes
Abe et al, 2019 [14]57FAlcohol4 daysSOB, hypoxemic0.97Diffuse ischemic TWILVEF 40%, basal segment hyperkinesis, apical akinesisNo
Ashraf et al, 2019 [15]64FUnknown5 daysSOBElevatedAnterior ST elevationLVEF 30-35%, mid-to-apical segments hypokinetic to akineticYes
Yeh et al [2]27MAlcoholSame dayChest pain1,019.63Anterior ST elevationLVEF 20%, basal hyperkinesis, apical akinesis-
Khan, 2022 [16]30FGallstone s/p ERCP1 dayChest pain3.965Anteroseptal ST elevationPreserved LV function with apical ballooning-
Dhruv et al, 2023 (current case 1)41MAlcohol2 daysAsymptomatic300 ng/L (high-sensitivity troponin, normal value < 14 ng/L)Diffuse TWILV function with an EF of 25-30%, apical ballooning and akinesia of the mid-apical myocardium-
Dhruv et al, 2023 (current case 2)41FGallstones2 daysSOB800 ng/L (high-sensitivity troponin, normal value < 14 ng/L)Diffuse TWILV function EF 35% with apical hypokinesisYes