A Case of Takotsubo Cardiomyopathy Complicated with Life Threatening Arrhythmia and Cardiogenic Shock

Philip Tulio¹, Jehad Azar^1, , Keyvan Ravakhah², Randol Kennedy¹ and Vasant Temull¹

¹Internal Medicine Resident, St. Vincent Charity Medical Center, Cleveland, USA

²Chairman of Internal Medicine, St. Vincent Charity Medical center, Cleveland, USA

Cite this paper

Philip Tulio, Jehad Azar, Keyvan Ravakhah, Randol Kennedy and Vasant Temull. A Case of Takotsubo Cardiomyopathy Complicated with Life Threatening Arrhythmia and Cardiogenic Shock. American Journal of Medical Case Reports. 2019; 7(6):109-116. doi: 10.12691/AJMCR-7-6-4

Abstract

Stress (Takotsubo) cardiomyopathy (CM) is defined as a transient regional systolic dysfunction of the left ventricle that mimics acute coronary syndrome (ACS) in the absence of significant coronary artery disease or plaque rupture. This phenomenon commonly occurs in postmenopausal females in the presence of emotional, physical and psychological stressors with excess catecholamine stimulation, resulting in diffuse microvascular spasm and subsequently myocardial stunning. Here we report a 58-year-old postmenopausal female patient with end stage renal disease (ESRD) who was presented to our hospital with a clinical picture suggesting ACS. Shortly after admission she progressed to cardiogenic shock and pulseless electrical activity (PEA) and was diagnosed retrospectively with Takotsubo cardiomyopathy. She was successfully treated with beta-blockers, IV fluids and inotropic agents. Intra-aortic balloon pump (IABP) was considered, however, the patient gradually improved to full recovery with resolution of left ventricular function back to normal.

Keywords

Takotsubo, stress cardiomyopathy, arrhythmia, cardiogenic shock, Intra-aortic balloon pump, Left ventricular outflow tract obstruction

Copyright

This work is licensed under a Creative Commons Attribution 4.0 International License. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/

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