Catecholamine-induced reverse takotsubo cardiomyopathy

Area of Science:

• Cardiology
• Pharmacology
• Toxicology

Background:

• Takotsubo cardiomyopathy (TTC) is a transient heart condition mimicking myocardial infarction.
• It typically affects postmenopausal women and is triggered by stress.
• Obstructive coronary artery disease is absent in TTC.

Observation:

• A young male patient presented with anaphylaxis and angioedema.
• He received an iatrogenic overdose of epinephrine for treatment.
• The patient subsequently developed reverse takotsubo cardiomyopathy with apical sparing.

Findings:

• The case demonstrates reverse takotsubo cardiomyopathy, a variant with basal hyperkinesis and apical hypokinesis.
• Apical sparing was noted in the patient's cardiac imaging.
• Epinephrine overdose was identified as the causative factor.

Implications:

• This case expands the understanding of takotsubo cardiomyopathy triggers beyond emotional or physical stress.
• It highlights the potential for iatrogenic causes, such as medication overdose, to induce cardiac dysfunction.
• Clinicians should consider drug-induced cardiomyopathy in the differential diagnosis of patients presenting with acute cardiac symptoms, especially after medication administration.