Respiratory Disease Induced Recurrent Takotsubo Cardiomyopathy

Document Type

Conference Proceeding - Restricted Access

Publication Date

5-8-2026

Abstract

Takotsubo cardiomyopathy (TTC), also known as stress cardiomyopathy, is an acute reversible heart failure syndrome. Initially considered quite rare, incidence has increased over the past 20 years, likely due to greater awareness and improved diagnostic capabilities. Recurrent episodes in a single patient are exceedingly uncommon, and predictive factors are not clear. Here we discuss a patient that experienced multiple recurrences of TTC in the setting of exacerbated respiratory disease.

A 63-year-old male with chronic obstructive pulmonary disease (COPD) was admitted in 2020 for worsened COPD. Transthoracic echocardiogram (TTE) revealed a left ventricular ejection fraction (LVEF) of 21% with distal segment akinesis. Coronary angiography showed moderate coronary artery disease with insignificant fractional flow reserve. He was diagnosed with TTC. Repeat TTE weeks later revealed improved LVEF to 51% and resolution of wall motion abnormalities. He was admitted in 2023 for a COPD exacerbation. TTE revealed a LVEF of 34% with apical segment akinesis. Coronary angiography showed unchanged coronary disease. He was diagnosed with recurrent TTC. Repeat TTE showed LVEF 56% and no wall motion abnormalities. He was admitted again in 2025 for COPD. TTE showed a LVEF of 39% with apical segment akinesis. Coronary angiography again showed stable coronary disease. He was diagnosed with a third episode of TTC. Repeat TTE showed an LVEF of 51% with resolution of apical segment akinesis.

Recurrent TTC is a rare but important consideration for patients presenting with recurrent cardiomyopathy. Typically, diagnosis involves excluding significant underlying coronary artery disease as well as complete reversal of wall motion abnormalities and recovery of LVEF, usually within days to weeks. Our patient uniquely presented with three episodes of TTC, all precipitated by the same physical trigger of COPD.

Comments

2026 Research Day Corewell Health West, Grand Rapids, MI, May 8, 2026. Abstract 2076

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