Triptan-induced takotsubo syndrome: a case report.

Background: Takotsubo syndrome (TS) is a clinical condition mimicking acute coronary syndrome characterized by reversible acute systolic dysfunction. TS is typically associated with a catecholaminergic surge resulting from physical or emotional stress while some pharmacologic agents may act as a trigger. Case summary: Here, we report a case of TS secondary to rizatriptan, used for treatment of acute migraine. A 67-year-old woman with a history of dyslipidemia, type II diabetes, and migraine was admitted with chest heaviness shortly after taking rizatriptan for migraine. Deepening T wave inversion was seen in multiple territories on electrocardiogram and hs-troponin T was elevated. Cardiac imaging including echocardiogram coronary angiography and cardiac magnetic resonance imaging was consistent with a diagnosis of TS. Discussion: In this case, there was no emotional trigger for TS described. Given the compelling temporal correlation between the onset of typical chest pain and medication use, a diagnosis of TS secondary to rizatriptan was made.

Large Left Ventricular Outflow Tract Pseudoaneurysm Closed Percutaneously From a Novel Apical Approach.

An incidental finding of a large left ventricular outflow tract pseudoaneurysm in a 74-year-old man, with high surgical risk, was managed with a novel, fully percutaneous, left ventricular apical approach. The pseudoaneurysm defect and the apical puncture site were successfully closed with Amplatzer septal occluders with successful positioning, as demonstrated on cardiac computed tomography at 6 weeks follow-up. (Level of Difficulty: Intermediate.).