{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,2,21]],"date-time":"2025-02-21T19:03:14Z","timestamp":1740164594699,"version":"3.37.3"},"reference-count":24,"publisher":"Wiley","license":[{"start":{"date-parts":[[2017,1,1]],"date-time":"2017-01-01T00:00:00Z","timestamp":1483228800000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Case Reports in Critical Care"],"published-print":{"date-parts":[[2017]]},"abstract":"<jats:p><jats:italic>Introduction.<\/jats:italic> Patients with myasthenia crisis can develop Takotsubo stress cardiomyopathy (SC) due to emotional or physical stress and high level of circulating catecholamines. We report a patient who developed recurrent Takotsubo cardiomyopathy during myasthenia crisis. Coexisting autoimmune disorders known to precipitate stress cardiomyopathy like Grave\u2019s disease need to be evaluated.<jats:italic> Case Report.<\/jats:italic> A 69-year-old female with seropositive myasthenia gravis (MG), Grave\u2019s disease, and coronary artery disease on monthly infusion of intravenous immunoglobulin (IVIG), prednisone, pyridostigmine, and methimazole presented with shortness of breath and chest pain. Electrocardiogram (ECG) showed ST elevation in anterolateral leads with troponemia. Coronary angiogram was unremarkable for occlusive coronary disease with left ventriculogram showing reduced wall motion with apical and mid left ventricle (LV) hypokinesis suggestive of Takotsubo stress cardiomyopathy. Her symptoms were attributed to MG crisis. Her symptoms, ECG, and echocardiographic findings resolved after five cycles of plasma exchange (PLEX). She had another similar episode one year later during myasthenia crisis with subsequent resolution in 10 days after PLEX.<jats:italic> Conclusion.<\/jats:italic> Takotsubo cardiomyopathy can be one of the manifestations of myasthenia crisis with or without coexisting Grave\u2019s disease. These patients might benefit from meticulous fluid status and cardiac monitoring while administering rescue treatments like IVIG and PLEX.<\/jats:p>","DOI":"10.1155\/2017\/5702075","type":"journal-article","created":{"date-parts":[[2017,10,19]],"date-time":"2017-10-19T19:31:27Z","timestamp":1508441487000},"page":"1-5","source":"Crossref","is-referenced-by-count":4,"title":["A Case Report of Recurrent Takotsubo Cardiomyopathy in a Patient during Myasthenia Crisis"],"prefix":"10.1155","volume":"2017","author":[{"given":"Anusha","family":"Battineni","sequence":"first","affiliation":[{"name":"Department of Neurology, University of Missouri, 1 Hospital Drive, Columbia, MO 65212, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Naresh","family":"Mullaguri","sequence":"additional","affiliation":[{"name":"Department of Neurology, University of Missouri, 1 Hospital Drive, Columbia, MO 65212, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shail","family":"Thanki","sequence":"additional","affiliation":[{"name":"Department of Neurology, University of Missouri, 1 Hospital Drive, Columbia, MO 65212, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anand","family":"Chockalingam","sequence":"additional","affiliation":[{"name":"Department of Cardiology, University of Missouri, 1 Hospital Drive, Columbia, MO 65212, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0419-9072","authenticated-orcid":true,"given":"Raghav","family":"Govindarajan","sequence":"additional","affiliation":[{"name":"Department of Neurology, University of Missouri, 1 Hospital Drive, Columbia, MO 65212, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","reference":[{"key":"1","doi-asserted-by":"publisher","DOI":"10.1177\/1941875210382918"},{"key":"2","doi-asserted-by":"publisher","DOI":"10.1089\/thy.1997.7.631"},{"key":"3","doi-asserted-by":"publisher","DOI":"10.1002\/mus.22220"},{"key":"4","doi-asserted-by":"publisher","DOI":"10.1186\/1752-1947-4-393"},{"key":"5","doi-asserted-by":"publisher","DOI":"10.1136\/bcr.06.2008.0182"},{"key":"6","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijcard.2015.11.005"},{"key":"7","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijcard.2011.06.129"},{"key":"8","doi-asserted-by":"publisher","DOI":"10.1016\/j.ihj.2017.04.005"},{"key":"10","doi-asserted-by":"publisher","DOI":"10.1136\/bcr-2015-209631"},{"key":"11","doi-asserted-by":"publisher","DOI":"10.1007\/s10554-010-9590-7"},{"key":"12","doi-asserted-by":"publisher","DOI":"10.4103\/2230-8210.109666"},{"key":"13","doi-asserted-by":"publisher","DOI":"10.1097\/00041327-199509000-00008"},{"key":"14","doi-asserted-by":"publisher","DOI":"10.1002\/brb3.537"},{"issue":"2, author reply 284","key":"15","first-page":"283","volume":"51","year":"2003","journal-title":"Neurol India"},{"key":"16","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2044.2008.05496.x"},{"key":"17","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2249.1995.tb03674.x"},{"key":"18","doi-asserted-by":"publisher","DOI":"10.1210\/jc.82.2.438"},{"issue":"1","key":"19","first-page":"67","volume":"49","year":"2010","journal-title":"Acta clinica Croatica"},{"issue":"2","key":"20","volume":"28","year":"2015","journal-title":"Baylor University Medical Center Proceedings"},{"key":"21","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijcme.2014.08.003"},{"key":"22","doi-asserted-by":"publisher","DOI":"10.2215\/CJN.01701105"},{"key":"23","doi-asserted-by":"publisher","DOI":"10.1016\/j.ancard.2011.08.003"},{"key":"24","doi-asserted-by":"publisher","DOI":"10.1155\/2013\/863620"},{"issue":"3","key":"25","first-page":"207","volume":"44","year":"2004","journal-title":"Journal of Clinical Neurology"}],"container-title":["Case Reports in Critical Care"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/downloads.hindawi.com\/journals\/cricc\/2017\/5702075.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/downloads.hindawi.com\/journals\/cricc\/2017\/5702075.xml","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/downloads.hindawi.com\/journals\/cricc\/2017\/5702075.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2017,10,19]],"date-time":"2017-10-19T19:31:28Z","timestamp":1508441488000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.hindawi.com\/journals\/cricc\/2017\/5702075\/"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2017]]},"references-count":24,"alternative-id":["5702075","5702075"],"URL":"https:\/\/doi.org\/10.1155\/2017\/5702075","relation":{},"ISSN":["2090-6420","2090-6439"],"issn-type":[{"type":"print","value":"2090-6420"},{"type":"electronic","value":"2090-6439"}],"subject":[],"published":{"date-parts":[[2017]]}}}