Takotsubo Syndrome Associated with Isolated Hyponatremia: Case Report

Takotsubo Syndrome Associated with Isolated Hyponatremia: Case Report

Review Data

Q: Is the topic relevant to the journal area of interest? Is it contemporary and interesting for

researchers?

A: Very good

 

Abstract & Keywords

Q: Are all required components included in the abstract? Are the keywords appropriately chosen?

A: Very good

 

Goal

Q: Is the goal explicitly stated in the Introduction? Is its formulation clear and unambiguous?

A: Good

 

Structure

Q: Is the paper's structure coherent? Is it in coherence with the goal of the paper?

A: Very good

 

Tools and Methods

Q: Are methods the author uses adequate and well used?

A: Very good

 

Discussion & Conclusion

Q: Is it related to the results presented before? Do you consider them as coherent?

A: Excellent

 

Comments: The case description is adequate. The Discussion section provides an apt analysis of potential triggering factors, responsible for the development of takotsubo syndrome (TTS) associated with severe hyponatremia and syndrome of inappropriate antidiuretic hormone (SIADH). It identifies lisinopril as the most likely triggering factor of SIADH and drug-induced hyponatremia. The Conclusion establishes the role of losartan therapy which prevents the development of hyponatremia in the patient.

 

Literature

Q: Does the author utilize relevant literature?

A: Very good

 

Author's knowledge

Q: What is the level of the author’s knowledge? Does the author utilize all recent contributions relevant to the topic?

A: Very good

 

Length

Q: Is the length of the paper adequate to the significance of the topic? Do you suggest shortening the paper without losing its value?

A: Good

 

Figures & Tables

Q: Does the author use them suitably? Are legend and notations clear?

A: Excellent

 

Writing style

Q: Is it clear and understandable?

A: Good

 

Comments:

 

·       The last sentence of the 1st paragraph of the Discussion and Conclusion should be rephrased as “Another suggested mechanism is that hyponatremia could interfere with myocardial inotropism by modulation of cardiomyocyte Na+/Ca2+ exchange which results in hypotonicity-induced myocardial swelling”.

 

Further comments on the paper

Comments: This case report investigates a case of a takotsubo syndrome (TTS) associated with isolated hyponatremia in a 73-year-old woman, presented with acute dyspnea, chest pain and general malaise, with a history of arterial hypertension, controlled by lisinopril. Although numerous triggering factors are responsible for the development of TTS, the pathophysiological link between TTS and hyponatremia is still not evident. This study demonstrates that lisinopril, an angiotensin-converting enzyme (ACE) inhibitor appears to be a potent triggering factor of syndrome of inappropriate antidiuretic hormone (SIADH) in the presence of increased fluid uptake. This study also highlights the effectiveness of losartan therapy which results in a complete recovery of left ventricular function and the patient did not develop hyponatremia.

 

Q: Would you recommend this manuscript for further publication?

A: Yes - Suitable to be published

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Author Info

Corresponding Author
P Hantson
Department of Intensive Care, Cliniques St-Luc, Université catholique de Louvain, Brussels, Belgium

Article Info

Article Type
Case Report
Publication history
Received: Thu 24, Dec 2020
Accepted: Thu 07, Jan 2021
Published: Mon 25, Jan 2021
Copyright
© 2023 P Hantson. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Hosting by Science Repository.
DOI: 10.31487/j.JICOA.2021.01.07