Takotsubo cardiomyopathy in chronic infection.
BACKGROUND
Takotsubo cardiomyopathy is the acquired, reversible syndrome characterised by apical ballooning and base hypercontractility and probably precipitated by emotional and physical stressors that cause a hyperadrenergic state. It presents as an acute coronary event without there being coronary disease.


METHODS
We present a case of a 73-year-old woman who developed takotsubo cardiomyopathy with concomitant septic shock from a chronic hemiarthroplasty site infection. The prosthesis had been removed, the surgical site drained twice and multiple antibiotics prescribed. She also had a previous episode of sepsis from she recovered with vasopressor support.


CONCLUSIONS
To the author's knowledge, this is the first case of this syndrome occurring in such a prolonged septic process and where the primary focus was a surgical wound. This may indicate continued myocardial injury secondary to a sustained hyperadrenergic state as a possible mechanism for takotsubo cardiomyopathy, rather than a one-time catecholamine surge.
Foundation Doctor, Department of Cardiac Services, Mater Dei Hospital, Malta.
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Galea
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Abela
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Felice
D000368:Aged; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D002908:Chronic Disease; D017023:Coronary Angiography; D004562:Electrocardiography; D017809:Fatal Outcome; D005260:Female; D015600:Glasgow Coma Scale; D062785:Hemiarthroplasty / Q000009:adverse effects*; D006801:Humans; D012772:Shock, Septic / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy; D013530:Surgical Wound Infection / Q000150:complications* / Q000209:etiology / Q000503:physiopathology / Q000628:therapy; D054549:Takotsubo Cardiomyopathy / Q000188:drug therapy / Q000209:etiology* / Q000503:physiopathology; D014662:Vasoconstrictor Agents / Q000627:therapeutic use
D000900:Anti-Bacterial Agents; D014662:Vasoconstrictor Agents
Takotsubo cardiomyopathy; chronic infection; sepsis; surgical site