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Takotsubo cardiomyopathy associated with syncope

Licheng Lee1, Thana Khawcharoenporn, Nalurporn Chokrungvaranon

  • 1Department of Medicine, John A. Burns School of Medicine, University of Hawaii, Honolulu, Hawaii 96813, USA.

Heart & Lung : the Journal of Critical Care
|March 4, 2009
PubMed

Insights

Syncope may trigger takotsubo cardiomyopathy, a stress-induced heart condition. This case highlights the potential link between profound hypotension and elevated norepinephrine levels causing cardiac dysfunction.

Area of Science:

  • Cardiology
  • Neurology

Background:

  • Takotsubo cardiomyopathy (TTC) is a reversible heart condition often triggered by emotional or physical stress.
  • Syncope, or fainting, can result from various physiological events, including sudden drops in blood pressure.

Observation:

  • An 81-year-old Japanese patient presented with syncope, followed by symptoms mimicking acute myocardial infarction.
  • Initial tests showed elevated cardiac enzymes and ECG changes suggestive of a heart attack.

Findings:

  • Cardiac catheterization revealed characteristic left ventricular apical ballooning and reduced ejection fraction, but no coronary artery blockages.
  • The patient experienced profound hypotension, potentially leading to baroreflex failure and a surge in norepinephrine.

Implications:

  • This case suggests that syncope-induced profound hypotension and subsequent norepinephrine surge may precipitate takotsubo cardiomyopathy.
  • Understanding this association is crucial for diagnosing and managing patients presenting with syncope and cardiac symptoms.

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