Title : Emotional and autoimmune triggers in takotsubo cardiomyopathy: A rare presentation in a young female with systemic lupus erythematosus
Abstract:
Background: Takotsubo Cardiomyopathy (TCM), a stress-induced cardiac condition, is characterized by transient left ventricular dysfunction often triggered by emotional stress. This case report explores TCM in a young female with a history of Systemic Lupus Erythematosus (SLE).
Case Presentation: A 27-year-old female presented to the emergency department with severe chest pain, palpitations, and shortness of breath following her father's death. She had a three-year history of SLE managed with hydroxychloroquine and corticosteroids. Physical examination revealed signs of distress and hypotension. ECG showed ST-segment elevations, and troponin I was elevated at 1.5 ng/mL. Coronary angiography ruled out ischemic heart disease, while echocardiography confirmed apical ballooning consistent with TCM. The patient received intravenous methylprednisolone for SLE exacerbation, beta-blockers, and supportive care. Her symptoms improved significantly, with normalization of cardiac markers and echocardiographic resolution of apical ballooning. She was discharged in stable condition and remained asymptomatic at three-month follow-up.
Discussion: This case illustrates the diagnostic challenges of TCM in the context of SLE, particularly when emotional stress is present. It emphasizes the importance of a multidisciplinary approach, combining cardiac and rheumatologic care, and highlights the interplay between emotional trauma and autoimmune inflammation in precipitating TCM.
Conclusion: TCM, particularly in young patients with autoimmune disorders, necessitates careful consideration and timely intervention to ensure favorable outcomes.
