We experienced three cases of Takotsubo syndrome with hemoptysis caused by a respiratory disease. All the patients were female with a mean age of 73.7 years. The underlying diseases were bronchiectasis (n = 1), non-tuberculous mycobacterial pulmonary disease (n = 1) and chronic pulmonary aspergillosis (n = 1). The patients presented with dyspnea or disturbance of consciousness. Takotsubo syndrome developed simultaneously with mild to moderate hemoptysis in two patients and eight days after admission in the other patient with severe hemoptysis. The severity of the hemoptysis did not appear to correlate to the occurrence of Takotsubo syndrome, and the peak BNP level was higher in patients with acute complications.
Clinicians should be aware that even mild hemoptysis due to a baseline respiratory disease may lead to Takotsubo syndrome especially in postmenopausal women with symptoms such as dyspnea.