A case of intracranial hemorrhage causing stress-induced cardiomyopathy

The classic finding of Takotsubo's cardiomyopathy is left ventricular systolic dysfunction with echocardiographic evidence of apical ballooning in the absence of significant coronary disease. Intracranial hemorrhage is a known cause for stress-induced cardiomyopathy with a similar echocardiographic presentation. This diagnostic finding suggests a similar pathophysiologic mechanism between neurogenic cardiac damage and the wide array of medical and psychosocial disorders that are known to cause stress-induced cardiomyopathy (Takotsubo's syndrome). The neurogenic-cardiac variant of stress-induced cardiomyopathy is associated with good cardiovascular prog- nosis; the hallmark feature of the disorder is complete echocardiographic resolution of systolic dysfunction within a short period of time. While malignant presentations are rare, the disorder can present as severe heart failure or ventricular tachyarrhythmias. We report a case of a near life-threatening episode of polymorphic ventricular tachycardia due to a subarachnoid hemorrhage (SAH)-induced stress-cardiomyopathy.