Takotsubo Syndrome Presenting with Intrauterine Fetal Death in Late Pregnancy: A Diagnostic Challenge with Peripartum Cardiomyopathy
Nergiz Aydın1
, Sefa Tatar2, Hakan Akıllı2, Yakup Alsancak2
1Department of Cardiology, Safranbolu State Hospital, Karabük, Türkiye
2Department of Cardiology, Necmettin Erbakan University Faculty of Medicine, Konya, Türkiye
Keywords: Acute heart failure; differential diagnosis; peripartum cardiomyopathy; pregnancy; Takotsubo syndrome.
Abstract
Peripartum cardiomyopathy (PPCM) is a major cause of heart failure in late pregnancy and the postpartum period, whereas takotsubo cardiomyopathy (TCM) is rare but may occur under severe stress. Differentiation between these conditions is challenging due to overlapping clinical features. A 30-year-old woman with an in vitro fertilization pregnancy presented at 34 weeks of gestation with dyspnea and intrauterine fetal demise. Echocardiography revealed severe left ventricular dysfunction (ejection fraction, 25%). Following surgical intervention and standard heart failure therapy, ventricular function improved rapidly, with the ejection fraction reaching 50% within one month. Despite pregnancy-related risk factors suggesting PPCM, the rapid recovery of left ventricular function favored a diagnosis of TCM. This case highlights the importance of careful clinical and imaging assessment and emphasizes that rapid ventricular recovery in late pregnancy should raise strong suspicion for TCM, even when classical PPCM risk factors coexist.
Cite This Article: Aydın N, Tatar S, Akıllı H, Alsancak Y. Takotsubo Syndrome Presenting with Intrauterine Fetal Death in Late Pregnancy: A Diagnostic Challenge with Peripartum Cardiomyopathy. Koşuyolu Heart J 0000;00(0):1–4.