Table 1 Summary of literature reporting on pancreatitis-induced TCM.
From: Takotsubo cardiomyopathy complicating acute pancreatitis: a case report
Authors | Sankri-Tarbichi et al. [3] | Rajani et al. [5] | Cheezum et al. [6] | Pednekar & Chandra [7] | Leubner et al. [8] | Bruenjas et al. [9] | Boulos [10] | Garbowska et al. [11] | Koop et al. [12] | Abe et al. [4] | Ashraf et al. [13] | Current case |
|---|---|---|---|---|---|---|---|---|---|---|---|---|
Age (years) | 56 | 72 | 76 | 70 | 76 | 55 | 47 | 47 | 63 | 57 | 64 | 27 |
Sex | Female | Female | Female | Female | Female | Male | Female | Female | Male | Female | Female | Male |
Aetiology of pancreatitis | Gallstones | – | Gallstones | – | Gallstones | Alcohol | – | Alcohol | Gallstones | Alcohol | Unknown | Alcohol |
Symptoms of pancreatitis | RUQ pain, nausea | Abdominal pain | N + V | RUQ pain | Epigastric pain, N + V | Epigastric pain, N + V | Epigastric pain | Epigastric pain, N + V | Epigastric pain, N + V | Abdominal pain, N + V | Epigastric pain, vomiting | Epigastric pain, N + V diaphoresis |
Time to TCM | 3 days | 7 days | 2 days | Same day | 1 day | Same day | – | 7 days | 3 days | 4 days | 5 days | Same day |
Systemic inflammation | – | – | WCC 23.3 × 109/L | – | Mild leukocytosis | – | – | WCC 19.52 × 109/L, CRP 293.8 mg/L | WCC 11.5 × 109/L | WCC 14.6 × 109/L | – | WCC 17.2 × 109/L |
Symptoms of TCM | SOB, chest pain, nausea | Chest pain | Tachypnoea, hypoxemic | Cardiac arrest | SOB, diaphoresis | Chest pain, diaphoresis, nausea | Nausea | Chest pain, SOB | Oliguria, hypotension, SOB, PEA arrest | SOB, hypoxemic | SOB | Chest pain |
Troponin (ng/mL; reference < 0.02) | 2.39 | 0.32 | 0.67 | 3.13 | 9.94 | 0.66 | 0.3 | 9.65 | 0.02 | 0.97 | Elevated | 1019.63 |
ECG | TWI V2-5 | Inferolateral TWI | Lateral ST elevation | Inferior ST elevation, anterior TWI | Anteroseptal ST elevation | Generalised ST depression + TWI | Inferolateral TWI | ST elevation V2 | Non-specific inferolateral T-wave changes | Diffuse ischemic TWI | Anterior ST elevation | Anterior ST elevation |
Chest radiography | Pulmonary oedema | – | Pulmonary oedema, bilateral pleural effusions | – | Mild pulmonary oedema, bilateral pleural effusions | – | – | Pulmonary congestion | Acute pulmonary oedema | Pulmonary oedema | Pulmonary oedema | – |
Echocardiogram or ventriculography | LVEF 25%, severe apical hypokinesia/ akinesia of left ventricle, hypercontractile base | Apical akinesis | LVEF 30%, severe apical hypokinesis + hyperdynamic basal contraction | LVEF 30% | LVEF 30–35%, hypokinetic apical left ventricle | LVEF 25%, apical ballooning, hypercontractile basal segments | Akinesis of distal anterior, lateral, inferior walls of left ventricle | LVEF 25%, apical ballooning, hypercontractile basal segments of left ventricle | LVEF 20–25%, new-onset cardiomyopathy, global hypokinesis | LVEF 40%, basal segment hyperkinesis, apical akinesis | LVEF 30–35%, mid-to-apical segments hypokinetic to akinetic | LVEF 20%, basal hyperkinesis, apical akinesis |
Angiography | Normal coronary arteries | Unobstructed coronary arteries | Mild non-obstructive CAD | No obstructive atherosclerotic disease | No CAD | No obstructive CAD | Not done—myocardial nuclear stress test mildly abnormal | Normal coronary arteries | 50% LAD stenosis, otherwise no obstructive CAD | Normal coronary arteries | Only luminal irregularities | Non-obstructive CAD |
Treatment of TCM | Aspirin, BB, ACEi | BB, ACEi | BB, ACEi | BB, ACEi | – | Aspirin, BB, ACEi, warfarin | – | – | Left ventricular assist device | BB, ACEi | BB, ACEi | BB, ACEi |
Recovery of LVEF | Yes | – | Yes | Yes | – | Yes | – | Yes | Yes | No | Yes | – |
Time to recovery | 10 days | – | 2 weeks | 6 weeks | – | 3 weeks | – | 10 days | 3 weeks | – | 6 weeks | – |