Cor Vasa 2022, 64(5):549-553 | DOI: 10.33678/cor.2022.001

Atypical presentation of Takotsubo syndrome early after pacemaker implantation

Elisabetta Demurtas^a, Davide Restelli^a, Lorenzo Pistelli^a, Francesca Parisi^a, Alessia Perna^a, Paolo Vinciguerra^a, Rosalba De Sarro^a, Alessio Currò^b, Sergio Crosca^c

^a Department of Clinical and Experimental Medicine, University of Messina, Italy

^b Cardiac Intensive Care, PO Piemonte, IRCCS Neurolesi Messina, Italy

^c Internal Medicine Unit, Hospital of Lipari, ASP 5 Messina, Italy

Background: Takotsubo syndrome is a form of acute stress-induced cardiomyopathy showing left ventricular dysfunction without, in most cases, obstructive coronary artery disease, although these can be present in 10-29% of cases. Even a low invasive procedure, representing a physical and emotional stress, could be associated with the onset of Takotsubo syndrome. Case presentation: We report the case of an 87-year-old woman with high pre-existing stress load who developed Takotsubo syndrome with uncommon symptoms after an uncomplicated placement of a permanent pacemaker.

Conclusions: This case remarks that TTS should be considered as a potential complication after pacemaker implantation, especially in post-menopausal women. Multicentre registers and more studies are needed to better understand how and in which category of patients also low invasive procedures could be associated with TTS.

Keywords: Atrio-ventricular block, Cardiac device implantation, Isoprenaline, Pacemaker implantation, Takotsubo cardiomyopathy, Takotsubo syndrome

Received: November 14, 2021; Revised: January 12, 2022; Accepted: January 14, 2022; Published: November 1, 2022  Show citation