Takotsubo syndrome with concomitant coronary angioplasty and implantable cardioverter-defibrillator implantation: a case report.

Often considered benign, Takotsubo syndrome (TTS) could be life threatening. We present a 54-year-old female patient with a history of heterozygous beta-thalassaemia and Graves' disease who came to the emergency department complaining of dizziness, atypical chest pain and an episode of collapse. The patient developed cardiac arrest due to ventricular fibrillation. After 45 minutes of cardiopulmonary resuscitation, return of spontaneous circulation was achieved. A transthoracic echocardiography revealed hypokinetic mid and apical left ventricular (LV) segments. Her coronary angiography showed significant stenosis in the left anterior descending coronary artery, for which she underwent percutaneous coronary intervention. In the subacute phase, she had episodes of polymorphic ventricular tachycardia in the context of QT-interval prolongation. Cardiac magnetic resonance imaging demonstrated diffuse myocardial oedema in the mid and apical segments of the LV. Finally, after 60 days of hospitalisation, an implantable cardioverter-defibrillator was implanted for secondary prevention of sudden cardiac death. This case study demonstrates some of the serious complications of TTS and the medical decisions that may need to be made regarding its treatment course.