Takotsubo cardiomyopathy with left ventricular thrombus presenting as critical limb ischaemia.
Takotsubo cardiomyopathy (TC) is a rare condition, characterized by acute left ventricular (LV) dysfunction in the absence of flow-limiting coronary artery disease, usually provoked by a physical or emotional stressor. The condition is far more common in women. The commonest presenting symptoms in patients with TC are chest pain and shortness of breath, often mimicking an acute coronary syndrome. A number of complications of TC are recognized, and very rarely patients experience cardioembolic phenomena secondary to LV thrombus formation in TC. We present the case of a 48-year-old lady presenting with peripheral limb ischaemia, subsequently found to have an LV thrombus secondary to TC. Diagnosis of TC was made challenging by the absence of chest pain. She required urgent arterial embolectomy and was treated with 6-month oral anticoagulation therapy. She was also commenced on beta-blocker and angiotensin-converting enzyme inhibitor treatment for the management of LV dysfunction.
Department of Cardiovascular Sciences, University Hospitals of Leicester NHS Trust , Glenfield General Hospital , Leicester , UK.
Gaurav
G
Gulsin
Department of Cardiovascular Sciences, University Hospitals of Leicester NHS Trust , Glenfield General Hospital , Leicester , UK.
Solange
S
Serna
University Hospitals of Leicester NHS Trust , Glenfield General Hospital , Leicester , UK.
Clare
C
Morris
Department of Cardiovascular Sciences, University Hospitals of Leicester NHS Trust , Glenfield General Hospital , Leicester , UK.
Abutariq
A
Taher
Department of Cardiovascular Sciences, University Hospitals of Leicester NHS Trust , Glenfield General Hospital , Leicester , UK.
Ian
I
Loke
Cardiol J. 2008;15(6):572-7
19039766
JACC Cardiovasc Imaging. 2010 Nov;3(11):1200-1; author reply 1201
21071010
Am Heart J. 2012 Jul;164(1):66-71.e1
22795284
Br J Haematol. 2011 Aug;154(3):311-24
21671894
Int J Cardiol. 2008 Dec 17;131(1):18-24
18692258
Eur Heart J. 2006 Jul;27(13):1523-9
16720686
Circulation. 2011 Nov 1;124(18):e460-2
22042929