Takotsubo cardiomyopathy in myasthaenia gravis crisis confirmed by cardiac MRI

BMJ Case Rep. 2015 Sep 28:2015:bcr2015209631. doi: 10.1136/bcr-2015-209631.

Abstract

Myasthaenia gravis crisis and Takotsubo cardiomyopathy are rare conditions that can be precipitated by emotional or physical stress. Myasthaenia gravis has a variety of cardiac manifestations but Takotsubo cardiomyopathy, particularly in male patients, has rarely been reported. We describe a unique case of a 70-year-old man who developed Takotsubo cardiomyopathy during his first presentation with a myasthaenia gravis crisis. He had not received plasmapharesis or immunoglobulin therapy. Striking ECG traces and cardiac MRI helped to confirm the diagnosis. Cardiac manifestations of myasthaenia gravis and myasthaenia gravis itself have overlapping symptoms; the importance of cardiac monitoring and clinical vigilance in such cases is discussed. The utility of cardiac MRI in assessing cardiac manifestations of myasthaenia gravis is also highlighted.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Electrocardiography / methods
  • Humans
  • Magnetic Resonance Imaging / methods
  • Male
  • Myasthenia Gravis / complications*
  • Myasthenia Gravis / diagnosis*
  • Myasthenia Gravis / drug therapy
  • Takotsubo Cardiomyopathy / complications*
  • Takotsubo Cardiomyopathy / diagnosis*
  • Takotsubo Cardiomyopathy / drug therapy