Monday, 1 May 2017

Heart Failure during Relapse

Androdias G, Bernard E, Biotti D, Collongues N, Durand-Dubief F, Pique J, Sanchez I, Delmas C, Ninet J, Marignier R, Vukusic S.
Multiple sclerosis broke my heart. Ann Neurol. 2017. doi: 10.1002/ana.24935. [Epub ahead of print]
We report 5 cases of acute heart failure (AHF) related to multiple sclerosis (MS) relapses. AHF was inaugural in 3 patients, always preceded or accompanied by signs of brainstem dysfunction; it was severe, requiring intensive care management. Echocardiography showed left ventricular hypokinesis. No other cause of AHF has been found. All patients showed a new medullary lesion on brain MRI. All had rapid and complete recovery of ventricular function after intravenous corticosteroids. We concluded to a takotsubo phenomenon. Physicians should be aware of rare cases of takotsubo cardiomyopathy in MS relapses. 

Takotsubo (after an Octupus trap in Japanese) cardiomyopathy, also known as Takotsubo syndrome, is a temporary condition where your heart muscle becomes suddenly weakened or ‘stunned’. The left ventricle, one of the heart’s chambers, changes shape and enlarges. This means this part of the heart doesn’t pump well.

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