Sinus Node Dysfunction in Takotsubo Syndrome: An Uncommon Presentation.
JACC Case Rep 2026 May 05; :108153. [Online ahead of print]

Abstract

BACKGROUND

Stress cardiomyopathy is an acute, usually reversible left ventricular (LV) systolic dysfunction often triggered by emotional or physical stress. Conduction system complications are uncommon.

CASE SUMMARY

A 68-year-old patient presented with acute pulmonary edema, reduced LV ejection fraction, and troponin elevation. Coronary angiography excluded obstructive coronary artery disease, and cardiac magnetic resonance confirmed stress cardiomyopathy. During hospitalization, the patient developed sinus node dysfunction (SND). Despite complete recovery of LV systolic function, the conduction abnormality persisted, requiring permanent pacemaker implantation.

DISCUSSION

Arrhythmias occur in up to one-quarter of patients with stress cardiomyopathy, most commonly atrial fibrillation or ventricular arrhythmias, whereas persistent SND is rare. This case highlights that recovery of ventricular systolic function does not necessarily indicate recovery of conduction abnormalities and underscores the need for careful rhythm monitoring and individualized pacing decisions.

TAKE-HOME MESSAGE

Persistent SND may complicate stress cardiomyopathy and may require permanent pacemaker implantation.

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Publisher Full Text (DOI)

Authors+Show Affiliations

Zakynthinos GEThird Department of Cardiology, "Sotiria" Chest Diseases Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece. Electronic address: gzakynthinos2@gmail.com.
Kalogeras KThird Department of Cardiology, "Sotiria" Chest Diseases Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece.
Vlachojannis GJThird Department of Cardiology, "Sotiria" Chest Diseases Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece.
Makavos GThird Department of Cardiology, "Sotiria" Chest Diseases Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece.
Kokkinos NKThird Department of Cardiology, "Sotiria" Chest Diseases Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece.
Souvaliotis NThird Department of Cardiology, "Sotiria" Chest Diseases Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece.
Katsianos EThird Department of Cardiology, "Sotiria" Chest Diseases Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece.
Vythoulkas-Biotis NThird Department of Cardiology, "Sotiria" Chest Diseases Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece.
Dilaveris PThird Department of Cardiology, "Sotiria" Chest Diseases Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece.
Siasos GThird Department of Cardiology, "Sotiria" Chest Diseases Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece.

Pub Type(s)

Case Reports
Journal Article

Language

eng

PubMed ID

42084574