{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,7,30]],"date-time":"2025-07-30T11:49:16Z","timestamp":1753876156032,"version":"3.41.2"},"reference-count":10,"publisher":"Oxford University Press (OUP)","issue":"3","license":[{"start":{"date-parts":[[2021,3,16]],"date-time":"2021-03-16T00:00:00Z","timestamp":1615852800000},"content-version":"vor","delay-in-days":16,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2021,2,28]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Biventricular Takotsubo cardiomyopathy (BTC) is estimated to occur in 25\u201342% of those with Takotsubo cardiomyopathy (TC). Little is known about which subset of patients are predisposed to having concomitant right ventricular (RV) involvement, or the pattern of recovery in BTC.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Case summary<\/jats:title>\n                  <jats:p>We describe a 69-year-old woman who presented with dyspnoea and was subsequently diagnosed with BTC. We propose that this was triggered by an exacerbation of chronic obstructive pulmonary disease on a background of multiple predisposing factors including recent bereavement, previous excessive alcohol use, status as a current smoker, and anxiety. During her admission, she required non-invasive ventilation and inotropic support to manage her type two respiratory failure and acute heart failure. Serial echocardiograms during the admission allowed us to capture and present the sequential recovery of ventricular systolic function, with the left ventricular (LV) recovery preceding the right ventricle.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Discussion<\/jats:title>\n                  <jats:p>Our patient fulfils the International Takotsubo Diagnostic criteria of transient LV dysfunction, emotional and physical triggers, electrocardiogram abnormalities, raised troponin and brain natriuretic peptide and no occlusive coronary artery disease. We hypothesize that pulmonary hypertension-related strain on the right ventricle due to lung disease, may have led to the observed delay in the recovery of RV function, despite the full recovery of LV function.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ehjcr\/ytab073","type":"journal-article","created":{"date-parts":[[2021,3,16]],"date-time":"2021-03-16T13:23:54Z","timestamp":1615901034000},"source":"Crossref","is-referenced-by-count":1,"title":["A case report: biventricular takotsubo cardiomyopathy with sequential ventricular recovery due to pulmonary hypertension"],"prefix":"10.1093","volume":"5","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9495-9279","authenticated-orcid":false,"given":"Megha","family":"Agarwal","sequence":"first","affiliation":[{"name":"Department of Cardiology, Milton Keynes University Hospital, 8H Standing Way, Eaglestone, Milton Keynes MK6 5LD, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Attila","family":"Kardos","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Milton Keynes University Hospital, 8H Standing Way, Eaglestone, Milton Keynes MK6 5LD, UK"},{"name":"School of Sciences and Medicine, University of Buckingham, Buckingham MK18 1EG, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2021,3,16]]},"reference":[{"key":"2021031611460737300_ytab073-B1","doi-asserted-by":"crossref","first-page":"2032","DOI":"10.1093\/eurheartj\/ehy076","article-title":"International Expert Consensus document on Takotsubo syndrome (part I): clinical characteristics, diagnostic criteria, and pathophysiology","volume":"39","author":"Ghadri","year":"2018","journal-title":"Eur Heart J"},{"key":"2021031611460737300_ytab073-B2","doi-asserted-by":"crossref","first-page":"1461","DOI":"10.1136\/heartjnl-2016-309783","article-title":"Takotsubo syndrome: aetiology, presentation and treatment","volume":"103","author":"Kato","year":"2017","journal-title":"Heart"},{"key":"2021031611460737300_ytab073-B3","first-page":"305","article-title":"Biventricular takotsubo cardiomyopathy: case study and review of literature","volume":"40","author":"Daoko","year":"2013","journal-title":"Tex Heart Inst J"},{"key":"2021031611460737300_ytab073-B4","doi-asserted-by":"crossref","first-page":"40","DOI":"10.1016\/j.ijcard.2014.10.143","article-title":"McConnell\u2019s sign\u2014an insight into the pathogenesis of Takotsubo syndrome?","volume":"178","author":"Shao","year":"2015","journal-title":"Int J Cardiol"},{"key":"2021031611460737300_ytab073-B5","first-page":"312","article-title":"Biventricular takotsubo cardiomyopathy: case report and general discussion","volume":"40","author":"Angelini","year":"2013","journal-title":"Tex Heart Inst J"},{"key":"2021031611460737300_ytab073-B6","doi-asserted-by":"crossref","first-page":"123","DOI":"10.1007\/s12574-019-00424-1","article-title":"Biventricular takotsubo cardiomyopathy with asymmetrical wall motion abnormality between left and right ventricle: a report of new case and literature review","volume":"17","author":"Tsugu","year":"2019","journal-title":"J Echocardiogr"},{"key":"2021031611460737300_ytab073-B7","doi-asserted-by":"crossref","first-page":"383","DOI":"10.1089\/thy.2012.0384","article-title":"Takotsubo cardiomyopathy associated with thyrotoxicosis: a case report and review of the literature","volume":"24","author":"Eliades","year":"2014","journal-title":"Thyroid"},{"key":"2021031611460737300_ytab073-B8","doi-asserted-by":"crossref","first-page":"2823","DOI":"10.1093\/eurheartj\/ehv757","article-title":"Happy heart syndrome: role of positive emotional stress in Takotsubo syndrome","volume":"37","author":"Ghadri","year":"2016","journal-title":"Eur Heart J"},{"key":"2021031611460737300_ytab073-B9","doi-asserted-by":"crossref","first-page":"700","DOI":"10.1016\/j.jacc.2009.10.031","article-title":"Pre-morbid psychiatric and cardiovascular diseases in apical ballooning syndrome (tako-tsubo\/stress-induced cardiomyopathy):potential pre-disposing factors?","volume":"55","author":"Summers","year":"2010","journal-title":"J Am Coll Cardiol"},{"key":"2021031611460737300_ytab073-B10","doi-asserted-by":"crossref","first-page":"2047","DOI":"10.1093\/eurheartj\/ehy077","article-title":"International Expert consensus document on Takotsubo syndrome (part II): diagnostic workup, outcome and management","volume":"39","author":"Ghadri","year":"2018","journal-title":"Eur Heart J"}],"container-title":["European Heart Journal - Case Reports"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/academic.oup.com\/ehjcr\/article-pdf\/5\/3\/ytab073\/36615457\/ytab073.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"http:\/\/academic.oup.com\/ehjcr\/article-pdf\/5\/3\/ytab073\/36615457\/ytab073.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,3,16]],"date-time":"2021-03-16T13:24:02Z","timestamp":1615901042000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/ehjcr\/article\/doi\/10.1093\/ehjcr\/ytab073\/6173875"}},"subtitle":[],"editor":[{"given":"Matteo","family":"Cameli","sequence":"additional","affiliation":[],"role":[{"role":"editor","vocabulary":"crossref"}]},{"given":"Luca","family":"Arcari","sequence":"additional","affiliation":[],"role":[{"role":"editor","vocabulary":"crossref"}]},{"given":"Mark","family":"Abela","sequence":"additional","affiliation":[],"role":[{"role":"editor","vocabulary":"crossref"}]},{"given":"Brett Sydney","family":"Bernstein","sequence":"additional","affiliation":[],"role":[{"role":"editor","vocabulary":"crossref"}]},{"given":"Ayse","family":"Djahit","sequence":"additional","affiliation":[],"role":[{"role":"editor","vocabulary":"crossref"}]}],"short-title":[],"issued":{"date-parts":[[2021,2,28]]},"references-count":10,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2021,2,28]]}},"URL":"https:\/\/doi.org\/10.1093\/ehjcr\/ytab073","relation":{},"ISSN":["2514-2119"],"issn-type":[{"type":"electronic","value":"2514-2119"}],"subject":[],"published-other":{"date-parts":[[2021,3,1]]},"published":{"date-parts":[[2021,2,28]]},"article-number":"ytab073"}}