• Internal medicine · Dec 2024

    Case Reports

    Myasthenic Crisis and Concomitant Takotsubo Syndrome Complicated by Shock: A Case Report.

    • Moeko Omiya, Yusuke Morii, Masako Mukai, Yuya Mitsuhashi, Ken Kato, and Toshiaki Isogai.
    • Department of Emergency and General Medicine, Tokyo Metropolitan Tama Medical Center, Japan.
    • Intern. Med. 2024 Dec 15; 63 (24): 338333873383-3387.

    AbstractA man in his 80s with myasthenia gravis (MG) developed dysmobility and chest discomfort. An electrocardiogram revealed ST-segment elevation, and coronary angiography revealed Takotsubo syndrome (TTS). He experienced myasthenic crisis that required ventilation and shock that was refractory to vasopressors and required intra-aortic balloon pump (IABP) insertion. He was managed conservatively without MG-specific treatment until his hemodynamics improved. On hospital day 6, he was weaned from IABP. MG is a high-risk condition for TTS, and TTS with myasthenic crisis (MC) is associated with high mortality. We successfully managed this case of TTS with MC with intubation and IABP, without MG-specific treatment.

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