title: Takotsubo cardiomyopathy in myasthaenia gravis crisis confirmed by cardiac MRI.
abstract: Myasthaenia gravis crisis and Takotsubo cardiomyopathy are rare conditions that can be precipitated by emotional or physical stress. Myasthaenia gravis has a variety of cardiac manifestations but Takotsubo cardiomyopathy, particularly in male patients, has rarely been reported. We describe a unique case of a 70-year-old man who developed Takotsubo cardiomyopathy during his first presentation with a myasthaenia gravis crisis. He had not received plasmapharesis or immunoglobulin therapy. Striking ECG traces and cardiac MRI helped to confirm the diagnosis. Cardiac manifestations of myasthaenia gravis and myasthaenia gravis itself have overlapping symptoms; the importance of cardiac monitoring and clinical vigilance in such cases is discussed. The utility of cardiac MRI in assessing cardiac manifestations of myasthaenia gravis is also highlighted.
authors.affiliation: Wiltshire Cardiac Centre, Swindon, UK.
authors.forename: I B
authors.initials: IB
authors.lastname: Harries
authors.affiliation: Wiltshire Cardiac Centre, Swindon, UK.
authors.forename: H
authors.initials: H
authors.lastname: Levoir
authors.affiliation: Bristol Heart Institute, Bristol, UK.
authors.forename: C
authors.initials: C
authors.lastname: Bucciarelli-Ducci
authors.affiliation: Wiltshire Cardiac Centre, Swindon, UK.
authors.forename: S
authors.initials: S
authors.lastname: Ramcharitar
mesh_terms: D000368:Aged; D004562:Electrocardiography / Q000379:methods; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D009157:Myasthenia Gravis / Q000150:complications* / Q000175:diagnosis* / Q000188:drug therapy; D054549:Takotsubo Cardiomyopathy / Q000150:complications* / Q000175:diagnosis* / Q000188:drug therapy