Neurological complications in Takotsubo syndrome: A case of concurrent acute stroke

Abstract

Takotsubo Syndrome (TTS), or stress cardiomyopathy, manifests as acute myocardial dysfunction mimicking acute coronary syndrome, with particular clinical relevance in post- menopausal women. Its diagnosis remains challenging due to overlapping features with other cardiovascular events, despite growing recognition. We report the case of a 76-year- old post-menopausal woman without major cardiovascular risk factors who developed TTS associated with ischemic stroke following the emotional stress of her son’s death. She initially presented with chest pain, later complicated by neurological deficits including weakness and speech impairment. Laboratory testing revealed elevated troponin levels, while echocardiography demonstrated typical TTS findings, further supported by the InterTAK diagnostic score and the absence of coronary obstruction on angiography. This case emphasizes the importance of considering TTS in elderly women under acute stress, highlighting the complex interplay between TTS and ischemic stroke. A multidisciplinary evaluation is required, while further studies are needed to clarify mechanisms and optimize management.