From assault to stroke: Takotsubo cardiomyopathy complicated by embolic infarctions: a case report

Takotsubo cardiomyopathy is a transient cardiac condition often triggered by sudden, severe emotional or physical stress. Although initially regarded as benign, thromboembolic complications occur in about 12% of patients, with cerebral infarction reported in up to 9.5% of cases. We describe a 57-year-old woman with hypertension who developed takotsubo cardiomyopathy following physical assault with chest trauma. She presented with chest pain and altered consciousness and was initially treated for acute coronary syndrome. Her coronary angiography was normal, and takotsubo cardiomyopathy was diagnosed based on characteristic echocardiographic features. The patient then developed an acute embolic stroke affecting both sides of the middle cerebral artery territory, requiring anticoagulation therapy. This case underscores the potentially serious thromboembolic complications of TC and highlights the importance of early recognition, appropriate consideration of anticoagulation, and multidisciplinary management. The clinical challenge of balancing bleeding and thrombotic risks in acute TC requires personalised decision-making and close monitoring.