A Case of Posterior Reversible Encephalopathy Due to Takotsubo Cardiomyopathy Triggered by Aerophobia

A 37-year-old woman, previously known to have severe airplane phobia, develops panic disorder-like symptoms in the second hour of flight. After a while, disorder was accompanied by chest pain and syncope. An ECG showed no abnormalities. Transthoracic echocardiogram demonstrated decreased left ventricular ejection fraction (EF: 30), large apical akinesis, characteristic regional wall motion abnormalities involving middle segments ventricle. Findings were consistent with Takotsubo cardiomyopathy. But emergency department, Brain Diffusion MRI cortical subcortical vasogenic edema posterior regions, predominantly on left, bilaterally, compatible reversible encephalopathy. This case highlights cardiomyopathy-related encephalopathy syndrome (PRES) managing disease.