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Bronchogenic stress cardiomyopathy: a case series
Adil Rajwani1, Zulfiquar Adam, James Anthony Hall
1Division of Cardiology and Cardiothoracic Surgery, The James Cook University Hospital, Middlesbrough, UK.
Cardiology
|January 24, 2015
Summary
Stress cardiomyopathy can be triggered by chronic obstructive pulmonary disease exacerbations. This condition, termed bronchogenic stress cardiomyopathy, presents atypically, often without chest pain, mimicking airway issues.
Area of Science:
- Cardiology
- Pulmonology
- Critical Care Medicine
Background:
- Stress (takotsubo) cardiomyopathy awareness is growing, but precipitants beyond emotional distress are under-appreciated.
- The type of precipitant may influence the variable presentations of stress cardiomyopathy.
Observation:
- Five cases of stress cardiomyopathy following acute exacerbations of chronic obstructive pulmonary disease (COPD) treated with high-dose bronchodilators were observed.
- These cases presented atypically and insidiously, mimicking the COPD exacerbation itself, notably lacking chest pain.
Findings:
- A novel bronchogenic subgroup of stress cardiomyopathy is suggested by these observations and a review of published case reports.
- Repeat electrocardiogram (ECG) evaluation is crucial for differentiating prolonged bronchospasm from bronchogenic stress cardiomyopathy.
Implications:
- This highlights an under-recognized association between COPD exacerbations, high-dose bronchodilator therapy, and stress cardiomyopathy.
- Further research is needed to confirm the role of high-dose beta-agonist therapy in bronchogenic stress cardiomyopathy.
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