"Inverted" tako-tsubo cardiomyopathy due to exogenous catecholamines.
Inverted tako-tsubo cardiomyopathy (TTC) is a variation of stress cardiomyopathy. It features transient myocardial dysfunction characterised by a typical contractile abnormality consisting of extensive left ventricular circumferential dyskinesia or akinesia with a hyperkinetic apex. Endogenous catecholamine surges are believed to be the mediators of this potentially life-threatening condition. We describe a patient who received an inadvertent bolus of noradrenaline and developed significant haemodynamic instability associated with electrocardiographic and cardiac biomarkers indicative of diffuse myocardial injury and echocardiography findings of an "inverted" TTC. The patient made a full recovery. Our case highlights that a reversible inverted TTC may result from an exogenous catecholamine surge.
Box Hill Hospital, Melbourne, VIC, Australia. catchdrash@yahoo.com
Ashwin
A
Subramaniam
Jennifer C
JC
Cooke
David
D
Ernest
D000328:Adult; D003402:Creatine Kinase / Q000097:blood; D004562:Electrocardiography; D005260:Female; D006801:Humans; D007022:Hypotension / Q000188:drug therapy; D008508:Medication Errors; D009638:Norepinephrine / Q000008:administration & dosage / Q000009:adverse effects*; D013566:Sympathomimetics / Q000008:administration & dosage / Q000009:adverse effects*; D054549:Takotsubo Cardiomyopathy / Q000139:chemically induced* / Q000000981:diagnostic imaging / Q000503:physiopathology; D013997:Time Factors; D020107:Troponin T / Q000097:blood; D014463:Ultrasonography; D018487:Ventricular Dysfunction, Left / Q000139:chemically induced / Q000000981:diagnostic imaging
D013566:Sympathomimetics; D020107:Troponin T; D003402:Creatine Kinase; D009638:Norepinephrine