Author/Authors :
Htay Kyi, Htay Hurley Medical Center, Flint, MI, USA , Alhesan, Nour Aljariri Hurley Medical Center, Flint, MI, USA , Upadhaya, Sunil Hurley Medical Center, Flint, MI, USA , Al Hadidi, Samer Hurley Medical Center -Michigan State University, Flint, MI, USA
Abstract :
Takotsubo cardiomyopathy (TC) is increasingly recognized in neurocritical care population especially in postmenopausal females.
We are presenting a 61-year-old African American female with past medical history of epilepsy, bipolar disorder, and hypertension
who presented with multiple episodes of seizures due to noncompliance with antiepileptic medications. She was on telemetry
which showed ST alarm. Electrocardiogram (ECG) was ordered and showed ST elevation in anterolateral leads and troponins were
positive. Subsequently Takotsubo cardiomyopathy was diagnosed by left ventriculography findings and absence of angiographic
evidence of obstructive coronary artery disease. Echocardiogram showed apical hypokinesia, ejection fraction of 40%, and systolic
anterior motion of mitral valve with hyperdynamic left ventricle, in the absence of intracoronary thrombus formation in the
angiogram. Electroencephalography showed evidence of generalized tonic-clonic seizure. She was treated with supportive therapy.
This case illustrates importance of ECG in all patients with seizure irrespective of cardiac symptoms as TC could be the cause of
Sudden Unexpected Death in Epilepsy (SUDEP) and may be underdiagnosed and so undertreated.
