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Stimulant-related Takotsubo cardiomyopathy
Mike Butterfield1, Christine Riguzzi2, Oron Frenkel2
1Tulane University Medical Center, New Orleans, LA.
The American Journal of Emergency Medicine
|October 14, 2014
Summary
Takotsubo cardiomyopathy, a stress-induced heart condition, can be triggered by crack cocaine. Early diagnosis is aided by recognizing the characteristic "ballooning" of the left ventricle on echocardiography.
Area of Science:
- Cardiology
- Toxicology
- Emergency Medicine
Background:
- Takotsubo cardiomyopathy (TC) mimics acute coronary syndrome, presenting with chest pain and ECG changes.
- While various stressors are linked to TC, drug-induced cases are infrequently reported.
- Crack cocaine is a potent stimulant with known cardiovascular effects.
Observation:
- A 58-year-old woman developed symptoms consistent with TC two days after using crack cocaine.
- Bedside echocardiography in the emergency department initially suggested the diagnosis of TC.
- The echocardiogram revealed apical hypokinesis, leading to the characteristic "ballooning" of the left ventricle during systole.
Findings:
- Crack cocaine use can precipitate Takotsubo cardiomyopathy.
- Echocardiography is crucial for the rapid identification of TC.
- The "ballooning" left ventricle is a hallmark echocardiographic finding in TC.
Implications:
- This case highlights the importance of considering illicit drug use in patients presenting with TC symptoms.
- Early recognition of TC through echocardiography can guide appropriate management.
- Further research into drug-induced TC is warranted given its potential underdiagnosis.
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