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DKA-Induced Takotsubo Cardiomyopathy in Patient with Known HOCM

Ayla Gordon1, Gina LaCapra1, Roberto Roberti1

  • 1Overlook Medical Center, Summit, NJ, USA.

Case Reports in Critical Care
|May 6, 2017
PubMed

Insights

Diabetic Ketoacidosis can induce Takotsubo cardiomyopathy, especially in patients with hypertrophic cardiomyopathy. This case highlights the complex interplay between DKA, TC, and HOCM, leading to syncope due to reduced brain perfusion.

Area of Science:

  • Cardiology
  • Endocrinology
  • Medical Case Reports

Background:

  • Diabetic Ketoacidosis (DKA) is a serious complication of diabetes.
  • Takotsubo cardiomyopathy (TC) is a temporary heart condition.
  • Hypertrophic cardiomyopathy (HOCM) is a genetic heart muscle disease.

Observation:

  • This report details the first case in the US of DKA-induced TC in a patient with known HOCM.
  • The patient presented with new-onset DKA and subsequent TC.
  • The interaction between DKA, TC, and HOCM presented unique clinical challenges.

Findings:

  • DKA precipitated TC in a patient with pre-existing HOCM.
  • The reduced ejection fraction (EF) from TC exacerbated the outflow tract obstruction in HOCM.
  • This led to transiently decreased cerebral perfusion, resulting in syncope.

Implications:

  • This case underscores the critical need to recognize DKA as a potential trigger for TC, particularly in patients with HOCM.
  • Understanding the biochemical and physiological mechanisms is crucial for managing these complex cases.
  • Early diagnosis and intervention are vital to prevent adverse outcomes like syncope and potential cardiac events.

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