Takotsubo Cardiomyopathy in Pregnancy

• Published in: Obstetrics and gynecology (New York. 1953) Vol. 112; no. 2; pp. 450 - 452
• Main Authors: Brezina, Paul, Isler, Christy M.
• Format: Journal Article
• Language: English
• Published: New York, NY The American College of Obstetricians and Gynecologists 01-08-2008; Elsevier Science
• Subjects: Adrenergic beta-Antagonists - therapeutic use; Adult; Biological and medical sciences; Cardiology. Vascular system; Echocardiography; Electrocardiography; Female; Gynecology. Andrology. Obstetrics; Heart; Humans; Medical sciences; Metoprolol - analogs & derivatives; Metoprolol - therapeutic use; Myocarditis. Cardiomyopathies; Pregnancy; Pregnancy Complications, Cardiovascular - diagnosis; Pregnancy Complications, Cardiovascular - drug therapy; Takotsubo Cardiomyopathy - diagnosis; Takotsubo Cardiomyopathy - drug therapy; Pregnancy; Cardiomyopathy; Heart disease; Gynecology; Cardiovascular disease; Female; Myocardial disease; Obstetrics
• ISSN: 0029-7844; 1873-233X
• DOI: 10.1097/AOG.0b013e3181662cfe

Takotsubo cardiomyopathy is a cardiac condition associated with the acute onset of chest pain, abnormalities in cardiac enzymes and electrocardiogram, and a distinct pattern of left ventricular dysfunction on echocardiography. This case evaluates an obstetric patient diagnosed with Takotsubo cardiomyopathy during her 23rd week of pregnancy.
A woman (G3P2002) at 23 weeks in an intrauterine pregnancy was admitted with chest pain. ST-segment elevation was noted on electrocardiogram with elevated cardiac enzymes. Subsequent tracings showed resolution of ST elevation with conservative management. Echocardiography was consistent with Takotsubo cardiomyopathy. She delivered through spontaneous vaginal delivery at term after a complete resolution of her cardiomyopathy.
Although uncommon, physicians who manage cardiac complications should be familiar with the diagnosis and management of Takotsubo cardiomyopathy.