title: Three-dimensional entertainment as a novel cause of takotsubo cardiomyopathy.
abstract: Takotsubo cardiomyopathy (TC) is an uncommon entity. It is known to occur in the setting of extreme catecholamine release and results in left ventricular dysfunction without evidence of angiographically definable coronary artery disease. There have been no published reports of TC occurring with visual stimuli, specifically 3-dimensional (3D) entertainment. We present a 55-year-old woman who presented to her primary care physician's office with extreme palpitations, nausea, vomiting, and malaise <48 hours after watching a 3D action movie at her local theater. Her electrocardiogram demonstrated ST elevations in aVL and V1, prolonged QTc interval, and T-wave inversions in leads I, II, aVL, and V2-V6. Coronary angiography revealed angiographically normal vessels, elevated left ventricular filling pressures, and decreased ejection fraction with a pattern of apical ballooning. The presumed final diagnosis was TC, likely due to visual-auditory-triggered catecholamine release causing impaired coronary microcirculation.
authors: Department of Internal Medicine, The Ohio State University Medical Center, Columbus, Ohio, USA.
authors: Montoya
authors: M
authors: Taylor
authors: Anish
authors: A
authors: Amin
authors: Charles
authors: C
authors: Bush
mesh_terms: D002395:Catecholamines / Q000378:metabolism; D017023:Coronary Angiography; D003326:Coronary Circulation; D004562:Electrocardiography; D005260:Female; D006801:Humans; D021621:Imaging, Three-Dimensional / Q000009:adverse effects*; D008279:Magnetic Resonance Imaging; D008833:Microcirculation; D008875:Middle Aged; D009040:Motion Pictures; D010775:Photic Stimulation; D013318:Stroke Volume; D054549:Takotsubo Cardiomyopathy / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology* / Q000378:metabolism / Q000503:physiopathology; D016277:Ventricular Function, Left
chemical_list: D002395:Catecholamines