Asthmatic Attack Complicated with Takotsubo Cardiomyopathy after Frequent Inhalation of Inhaled Corticosteroids/Long-Acting Beta2-Adrenoceptor Agonists.
A 63-year-old man was transferred to our hospital because of an exacerbation of asthma. His symptoms deteriorated even after increasing the dose of inhaled corticosteroids/long-acting beta2-adrenoceptor agonists (ICS/LABA). He had no chest pain and an electrocardiogram revealed ST elevation. A coronary angiogram revealed a reduced left ventricular function with an apical ballooning pattern without coronary stenosis. He was diagnosed with Takotsubo cardiomyopathy. Catecholamine elevation due to acute asthma and an overdose of ICS/LABA may be triggers of this disease. We should remember that Takotsubo cardiomyopathy is a complication of asthma and that catecholamine plays an important role in its onset, although it is essential for asthma treatment.
Division of Respiratory Medicine, National Center for Global Health and Medicine, Japan.
Nayuta
N
Saito
Manabu
M
Suzuki
Satoru
S
Ishii
Eriko
E
Morino
Jin
J
Takasaki
Go
G
Naka
Motoyasu
M
Iikura
Yuichiro
Y
Takeda
Masayuki
M
Hojo
Haruhito
H
Sugiyama
D000280:Administration, Inhalation; D000305:Adrenal Cortex Hormones / Q000009:adverse effects* / Q000627:therapeutic use*; D000318:Adrenergic beta-Agonists / Q000009:adverse effects* / Q000627:therapeutic use; D018927:Anti-Asthmatic Agents / Q000009:adverse effects* / Q000627:therapeutic use; D001249:Asthma / Q000188:drug therapy*; D006801:Humans; D007564:Japan; D008297:Male; D008875:Middle Aged; D054549:Takotsubo Cardiomyopathy / Q000188:drug therapy* / Q000209:etiology*
D000305:Adrenal Cortex Hormones; D000318:Adrenergic beta-Agonists; D018927:Anti-Asthmatic Agents