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Original research
Characteristics and outcome of patients with COVID-19 complicated by Takotsubo cardiomyopathy: case series with literature review
  1. Shruti Hegde1,
  2. Rizwan Khan1,
  3. Magdi Zordok2 and
  4. Michael Maysky1
  1. 1Cardiology, Caritas Saint Elizabeth's Medical Center, Brighton, Massachusetts, USA
  2. 2Internal Medicine, Caritas Carney Hospital, Dorchester, Massachusetts, USA
  1. Correspondence to Dr Shruti Hegde; shruti.hegde1587{at}


Background Cardiac involvement with COVID-19 is increasingly being recognised. Clinical characteristics and outcomes of patients with COVID-19 complicated by secondary Takotsubo cardiomyopathy (TC) is poorly understood.

Methods This retrospective case series was conducted between March and April 2020 at four hospitals of Steward Health Care Network of Massachusetts, USA. Seven patients out of 169 who had echocardiogram were identified to have features of TC. Demographic, clinical, laboratory, management and outcome were gathered from their electronic medical records. We also reviewed all the published cases of COVID-19 and TC in the literature to recognise their common clinical characteristics, risk factors and outcomes.

Results In our series of seven patients, three typical, two inverted, one biventricular and one global TC were recognised. Three were females and four were males. The mean age was 71±11 years. In-hospital death was observed in 57% of patients. Patients who belonged to the high-risk group and had high-risk echocardiographic features in our series had a 100% mortality rate.

Conclusions COVID-19 complicated by TC has a high mortality rate. Early identification of patients with COVID-19 who are at higher risk for developing secondary TC is important for the prevention of complications, and thus improved outcomes.

  • heart failure treatment
  • left ventricular assist device
  • echocardiography
  • stress

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  • Contributors All authors have contributed significantly to the content of the article.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data availability statement All data relevant to the study are included in the article or uploaded as supplementary information. All relevant data are included in the article.

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