A Case of Takotsubo Syndrome in a Smoker-Epileptic Patient With Rhinovirus Pneumonia in the Intensive Care Unit: Could the InterTAK Criteria Be Useful?

Takotsubo syndrome (TS) is an acute cardiac dysfunction that typically presents hypokinesis of the apical segment of the left ventricle beyond a single coronary artery territory. The pathological mechanisms of TS remain unclear, and several possible theories have been postulated, including catecholamine excess, coronary artery spasm, microvascular dysfunction, and metabolic disturbances. Based on the etiology, a primary and secondary form is distinguished. In primary TS, acute cardiac symptoms are the primary reason for seeking acute medical care. In secondary TS, the syndrome occurs in patients already hospitalized for a medical or surgical condition. The clinical conditions most frequently associated with TS are respiratory pathologies, sepsis, neurological disease, endocrine disease, and psychiatric pathologies. The incidence of TS is poorly studied in the critically ill patient setting; furthermore, it is very difficult to determine its incidence, duration, and progression from the current literature. We present the clinical case of a secondary TS in a smoker patient with a history of epilepsy, hospitalized in the ICU for respiratory failure due to viral pneumonia, complicated with bronchospasm, highlighting the diagnostic difficulties in critically ill patients, the presence of multiple trigger factors, and the need to perform an early diagnosis for patient survival.