Contributions
Abstract: P332
Type: Poster
Abstract Category: Clinical aspects of MS - MS symptoms
Objectives: To describe 5 cases of transient left ventricular dysfunction related to multiple sclerosis (MS) relapses and discuss pathophysiological processes.
Methods: Retrospective case series of 5 consecutive patients referred for acute heart failure associated with MS exacerbation in two French university hospitals.
Results: Transient cardiomyopathy developed in 5 MS patients (2 men and 3 women, aged 16 to 27) during a relapse that was inaugural in and led to the diagnosis of MS in 3 cases. Clinical signs of brainstem dysfunction preceded by a few days cardiac symptoms in 4 cases and were concomitant in one. Heart failure was severe in all patients, requiring intensive care management. Echocardiography showed left ventricular hypokinesis which was global in 2 patients and basal in 3. No other cause of acute heart failure has been found despite a comprehensive work-up. All patients had developed a new medullary lesion on brain MRI. Rapid and complete recovery of ventricular function was observed in all patients after intravenous corticosteroids and symptomatic cardiac treatment. We concluded to a takotsubo phenomenon.
Conclusion: Physicians should be aware that MS relapse is a rare but possible cause of takotsubo cardiomyopathy. Cardiologists in particular have to look for neurological symptoms in case of acute heart failure of unknown origin. In our series, all cases were associated with a new lesion of the medulla oblongata underlining the role of the brain-heart axis in this cardiomyopathy of incompletely understood pathogenesis.
Disclosure:
Dr Géraldine Androdias has received lecturing fees, travel grants and research support from Almirall, Biogen Idec, Genzyme, Novartis, Merck Serono, Sanofi and Teva Pharma
Dr Emilien Bernard has nothing to disclose
Dr Damien Biotti has nothing to disclose
Dr Nicolas Collongues has nothing to disclose
Dr Françoise Durand-Dubief has received lecturing fees, travel grants and research support from Biogen Idec, Genzyme, Novartis, Merck Serono, Sanofi and Teva Pharma
Dr Clément Delmas has nothing to disclose
Dr Jacques Ninet has nothing to disclose
Dr Romain Marignier has received lecturing fees, travel grants and research support from Biogen Idec, Genzyme, Novartis, Merck Serono, Sanofi and Teva Pharma
Dr Sandra Vukusic has received lecturing fees, travel grants and research support from Biogen Idec, Genzyme, Novartis, Merck Serono, Sanofi and Teva Pharma
Abstract: P332
Type: Poster
Abstract Category: Clinical aspects of MS - MS symptoms
Objectives: To describe 5 cases of transient left ventricular dysfunction related to multiple sclerosis (MS) relapses and discuss pathophysiological processes.
Methods: Retrospective case series of 5 consecutive patients referred for acute heart failure associated with MS exacerbation in two French university hospitals.
Results: Transient cardiomyopathy developed in 5 MS patients (2 men and 3 women, aged 16 to 27) during a relapse that was inaugural in and led to the diagnosis of MS in 3 cases. Clinical signs of brainstem dysfunction preceded by a few days cardiac symptoms in 4 cases and were concomitant in one. Heart failure was severe in all patients, requiring intensive care management. Echocardiography showed left ventricular hypokinesis which was global in 2 patients and basal in 3. No other cause of acute heart failure has been found despite a comprehensive work-up. All patients had developed a new medullary lesion on brain MRI. Rapid and complete recovery of ventricular function was observed in all patients after intravenous corticosteroids and symptomatic cardiac treatment. We concluded to a takotsubo phenomenon.
Conclusion: Physicians should be aware that MS relapse is a rare but possible cause of takotsubo cardiomyopathy. Cardiologists in particular have to look for neurological symptoms in case of acute heart failure of unknown origin. In our series, all cases were associated with a new lesion of the medulla oblongata underlining the role of the brain-heart axis in this cardiomyopathy of incompletely understood pathogenesis.
Disclosure:
Dr Géraldine Androdias has received lecturing fees, travel grants and research support from Almirall, Biogen Idec, Genzyme, Novartis, Merck Serono, Sanofi and Teva Pharma
Dr Emilien Bernard has nothing to disclose
Dr Damien Biotti has nothing to disclose
Dr Nicolas Collongues has nothing to disclose
Dr Françoise Durand-Dubief has received lecturing fees, travel grants and research support from Biogen Idec, Genzyme, Novartis, Merck Serono, Sanofi and Teva Pharma
Dr Clément Delmas has nothing to disclose
Dr Jacques Ninet has nothing to disclose
Dr Romain Marignier has received lecturing fees, travel grants and research support from Biogen Idec, Genzyme, Novartis, Merck Serono, Sanofi and Teva Pharma
Dr Sandra Vukusic has received lecturing fees, travel grants and research support from Biogen Idec, Genzyme, Novartis, Merck Serono, Sanofi and Teva Pharma