Acta Scientific Neurology (ASNE) (ISSN: 2582-1121)

Case Report Volume 3 Issue 5

Takotsubo Cardiomyopathy Resulting from Transient Global Amnesia Following a Sexual Encounter

Kamalpreet Dhaliwal, Sonia Randhawa, Nabihah Kabir, Yadwinder Sidhu, Harsimran Singh, Shawn Banash, Muhammed Janjua and Vibhav Bansal*

Department of Neurology, Mercy Health, Rockford, IL, USA

*Corresponding Author: Vibhav Bansal, Department of Neurology, Mercy Health, Rockford, IL, USA.

Received: April 15, 2020; Published: April 28, 2020

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Abstract

Introduction: Transient global amnesia (TGA) is a neurological condition described as acute onset anterograde amnesia that resolves within 24 hours. TGA is often associated with migraine history, psycho-physical stress, and cardiovascular risk factors. Takotsubo Cardiomyopathy (TTC), also known as Broken Heart Syndrome, is a reversible, stress-induced weakening of the left ventricle (LV) resulting in cardiomyopathy. Concurrent occurrence of the two syndromes have rarely been reported. To date, there have been 10 documented concurrent TGA and TTC cases, all unrelated to sexual triggers. Here we report the first patient with simultaneous TGA and TTC following a sexual encounter.

Insights and Aim: Summarize a case and its associated factors to establish awareness of a possible causal relationship between TGA and TTC following a sexual encounter as a precipitating factor. 

Case Report: A 66 year-old woman presented to the emergency department with sudden onset confusion and forgetfulness witnessed by the patient’s husband immediately after sexual intercourse.

Neurologic exam on admission revealed short-term memory deficits, resulting in repeated questions of similar nature regarding the peri-ictal period. Lab results revealed an elevated High Sensitivity Troponin-T of 51 ng/L (normal, < 14 ng/L); all other pertinent labs were within normal limits. The patient’s neurological manifestations of amnesia resolved 14 hours after the time of presentation.

Conclusion: Although TGA is considered a primary neurologic disorder, it is important to recognize a possible relationship between TGA and TTC in order to manage the cardiac complications that may arise from TTC.

Keywords: Stress Cardiomyopathy; Broken Heart Syndrome; Transient Global Amnesia; Heart Failure

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References

1. Han K., et al. “Transient Global Amnesia Linked to Impairment of Brain Venous Drainage: An Ultrasound Investigation”. Frontiers in Neurology 10 (2019): 67. 2. Mahler DE. “Transient Global Amnesia”. UpToDate (2019). 3. Misumi D., et al. “Coronary spasm as a cause of takotsubo cardiomyopathy and intraventricular obstruction”. Journal of Cardiology Cases 2.2 (2010): 83-87. 4. Pyle LM., et al. “Concomitant transient global amnesia and takotsubo cardiomyopathy following a stressful event”. Clinical Autonomic Research 28 (2018): 597-598. 5. Quick S., et al. “Transient global amnesia and broken heart syndrome: two faces of one pathology”. Clinical Autonomic Research 25 (2015): 189-191. 6. Reeder DS and Prasad D. “Clinical manifestations and diagnosis of stress (takotsubo) cardiomyopathy”. UpToDate (2019). 7. Rubaie KA and Arevalo JF. “Valsalva Retinopathy Associated with Sexual Activity”. Case Reports in Medicine (2014). 8. Stollberger C., et al. “Tako-tsubo cardiomyopathy with transient global amnesia and cerebellar embolic stroke triggered by existential fear”. Neurologia i Neurochirurgia Polska 52.3 (2018): 394-396. 9. Y-Hassan S and De Palma R. “Contemporary review on the pathogenesis of takotsubo syndrome: The heart shedding tears: Norepinephrine churn and foam at the cardiac sympathetic nerve terminals”. International Journal of Cardiology 228 (2017): 528-536. 10. Peggy Quinette., et al. “What does transient global amnesia really mean? Review of the literature and thorough study of 142 cases”. Brain 129.7 (2006): 1640-1658.
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Citation

Citation: Vibhav Bansal., et al. “Takotsubo Cardiomyopathy Resulting from Transient Global Amnesia Following a Sexual Encounter".Acta Scientific Neurology 3.5 (2020): 31-34.




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