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      Complete Heart Block Complicating Takotsubo Syndrome: Case Report and Literature Review

      case-report

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          Abstract

          An 81-year-old woman presents with shortness of breath resulting in a diagnosis of picornavirus and complete heart block. Troponin was elevated and there was concern about acute coronary syndrome. The final diagnosis after echocardiogram and coronary angiogram was Takotsubo syndrome in addition to the heart block which required pacemaker insertion.

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          Most cited references22

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          Prevalence and Clinical Significance of Life-Threatening Arrhythmias in Takotsubo Cardiomyopathy.

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            Institutional Variation in Quality of Cardiovascular Implantable Electronic Device Implantation

            Cardiovascular implantable electronic devices (CIEDs) are associated with procedure-related complications, yet little is known about variation in complication rates among institutions that may suggest disparities in care quality.
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              Enteroviral infection causing fatal myocarditis and subclinical myopathy.

              Enteroviral RNA detection in myocarditis and dilated cardiomyopathy is rare. Enteroviral particles and RNA have recently been identified in patient's skeletal muscle, suggesting that skeletal more than heart muscle hosts the virus in chronic infection. Enteroviral RNA and virus-like particles were found in the myocardium and in the skeletal muscle of two patients with fatal myocarditis: a 39 year old man who died five days after the onset of febrile flu; and a 49 year old woman, assisted for 50 days with a left ventricular assist device, who then died from cerebral haemorrhage. Automated sequencing, alignment, and sequence comparison confirmed the enteroviral origin of polymerase chain reaction products and excluded contamination. These findings agree with prior observations of enteroviral localisation in the skeletal muscle of patients with dilated cardiomyopathy, and further support the hypothesis that skeletal rather than heart muscle may host the virus and serve as a reservoir in cardiomyopathies related to chronic infection. enterovirus; myocarditis; viral particles; skeletal muscle
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                Author and article information

                Contributors
                Journal
                Case Rep Cardiol
                Case Rep Cardiol
                CRIC
                Case Reports in Cardiology
                Hindawi
                2090-6404
                2090-6412
                2020
                19 August 2020
                : 2020
                : 7614836
                Affiliations
                1School of Medicine and Public Health, University of Newcastle, Newcastle, NSW, Australia
                2Cardiovascular Department, John Hunter Hospital, Newcastle, NSW, Australia
                3Hunter Medical Research Institute, Newcastle, NSW, Australia
                Author notes

                Academic Editor: Manabu Shirotani

                Author information
                https://orcid.org/0000-0002-9713-0826
                Article
                10.1155/2020/7614836
                7453273
                3883388a-6ea9-4176-a0a8-928312da5382
                Copyright © 2020 Michael J. McGee et al.

                This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 30 March 2020
                : 1 June 2020
                : 7 July 2020
                Categories
                Case Report

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