P312 TAKOTSUBO SYNDROME DURING INFECTIVE ENDOCARDITIS: AN UNUSUAL COMBINATION

Abstract A 66–year–old woman presented to medical attention for low back pain, weight loss and evening fever about 2 weeks, with concomitant mood deflection. Blood cultures were positive Streptococcus mutans. Lumbar spondylodiscitis was found on spinal MRI splenic infarction abdominal ultrasound. The echocardiogram revealed the presence of vegetations aortic valve, which severely regurgitant, tricuspid moderately in a setting preserved biventricular dimensions function. patient diagnosed infective endocarditis, complicated by systemic embolization. hospital stay complicated, despite appropriate antibiotic therapy, acute pulmonary edema cardiogenic shock, sudden worsening left ventricular function became reduced, an "apical ballooning" appearance. Anterior T–wave inversion prolongation QT interval documented electrocardiogram. Coronary lesions excluded coronary CT scan. According InterTAK criteria, achieved score 80, suggestive high probability Takotsubo syndrome. In following days, thanks continuous infusion diuretics inotropic support, hemodynamic compensation obtained; there progressive recovery apical wall motion abnormalities, suspension support reduction dosage diuretic. We concluded syndrome endocarditis. patient, stabilized clinical picture, finally underwent cardiac surgery replace valves without complications. (TS) is condition characterized transient impairment kinetics, typically triggered physical or emotional stress. literature only four cases endocarditis TS are reported, other triggers recognizable (recent surgery, cerebral involvement embolization meningitis). our case, no apparent than Endocarditis could therefore represent itself new trigger even manifest, from beginning, TS.