Broken heart syndrome in a new mother with HELLP syndrome: a case report

Abstract

Abstract Introduction Takotsubo cardiomyopathy, more commonly known as broken heart syndrome, is increasingly being recognized as a clinical phenomenon and reported in the medical literature. This report discusses a case of broken heart syndrome in a new mother with hypertension, elevated liver enzymes, low platelets (HELLP) syndrome. Case report A 26-year-old primigravida developed acute-onset severe chest and epigastric pain 2 h after normal vaginal delivery. Investigations revealed that she had developed severe preeclampsia with HELLP syndrome (hypertension, elevated liver enzymes, low platelets) and acute renal failure. A marked rise in serial troponins was noted, and ECHO (echocardiogram) revealed hypokinesis of the basal segments of the heart. Cardiac MR (magnetic resonance) was consistent with catecholamine-induced Takotsubo cardiomyopathy. A multidisciplinary team was involved in the management. She made a good recovery, and follow-up with ECHO at 4 months revealed normal cardiac function. Conclusion Takotsubo cardiomyopathy is a rare reversible cardiac condition that should be differentiated from ischemic and peripartum cardiomyopathy. In pregnancy, it has an excellent prognosis with prompt multidisciplinary management.