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An unusual cardiomyopathy after physical stress in a child

Marianna Fabi1, Gabriella Testa, Valentina Gesuete

  • 1Pediatric Cardiology Unit, S. Orsola-Malpighi Hospital, Bologna, Italy.

Congenital Heart Disease
|January 12, 2012
PubMed

Insights

Takotsubo cardiomyopathy, a rare condition in children, can be triggered by infections. A 4-year-old celiac patient recovered rapidly after developing cardiac failure following diarrhea and fever.

Area of Science:

  • Cardiology
  • Pediatrics
  • Gastroenterology

Background:

  • Takotsubo cardiomyopathy (TTC), or broken heart syndrome, typically affects older women after emotional or physical stress.
  • It is characterized by transient left ventricular dysfunction mimicking acute coronary syndrome.
  • TTC is extremely rare in children and following infective stress.

Observation:

  • A 4-year-old girl with celiac disease, on a gluten-free diet, presented with cardiac failure symptoms.
  • These symptoms developed a few days after experiencing acute diarrhea and fever.
  • This case highlights an unusual presentation of TTC in a pediatric patient.

Findings:

  • The patient received oral anticongestive therapy and intravenous immunoglobulin treatment.
  • She demonstrated a dramatic and rapid clinical improvement.
  • Echocardiographic features of left ventricular dysfunction normalized within 48 hours.

Implications:

  • This case suggests that infective triggers, like gastroenteritis, can precipitate Takotsubo cardiomyopathy in children.
  • It underscores the importance of considering cardiac involvement in pediatric patients presenting with severe infections and heart failure symptoms.
  • Early diagnosis and appropriate treatment, including immunoglobulins, may lead to rapid recovery in pediatric TTC.

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