ArticleJournal of cardiology cases2026
Takotsubo syndrome presenting as ventricular fibrillation cardiopulmonary arrest coupled with complete heart block.
Article in Journal of cardiology cases, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Life-threatening arrhythmia can occur in patients with takotsubo syndrome (TTS). However, it is unusual for a TTS patient to present with ventricular fibrillation cardiopulmonary arrest (VF-CPA) coupled with complete heart block at the initial presentation. An 83-year-old woman underwent a VF-CPA. After she was successfully defibrillated, her electrocardiogram showed deep T-wave inversions with unusually prolonged QT-intervals (QTc = 0.493) at leads V1-V6 together with complete heart block. Echocardiogram and left ventriculogram showed broad ballooning from the mid left ventricle (LV) to the apex, consistent with TTS. A repeated echocardiogram 11 days after the VF-CPA event showed total recovery of the LV wall motion. She later testified that she had experienced slow pulse rate 3 days prior to the event. In conclusion, TTS presenting as VF-CPA as well as complete heart block is most unusual. As a possible sequence of events, it is postulated that TTS triggered by complete heart block was followed by VF-CPA. Prominent post-TTS QT prolongation, partly influenced by complete heart block, is considered as a possible mechanism for the VF-CPA event in this TTS patient. Learning objective: Although life-threatening arrhythmia can occur in patients with takotsubo syndrome (TTS), a TTS patient presenting with ventricular fibrillation cardiopulmonary arrest (VF-CPA) together with complete heart block is most unusual. Prominent post-TTS QT prolongation, partly influenced by complete heart block, is considered as a possible mechanism for the VF-CPA event in this TTS patient. It is important to recognize that TTS may be at times triggered by complete heart block.
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