‘Broken heart’ in acute-on-chronic liver failure

Abstract

Takotsubo cardiomyopathy usually occurs as a result of catecholamine release causing myocardial ‘stunning’ during physical or emotional stress. Typically coronary angiogram shows normal or minor coronary artery disease and echocardiogram shows apical ballooning with basal wall hyperkinesia. The prognosis is excellent with good cardiac functional recovery within days to weeks. We report the first case of takotsubo cardiomyopathy in a patient with acute-on-chronic liver failure.