Recurrent Takotsubo Syndrome Due to Hypoglycemic Attacks

Area of Science:

• Cardiology
• Endocrinology
• Critical Care Medicine

Background:

• Takotsubo syndrome (TTS) is characterized by transient left ventricular dysfunction.
• While stress is a common trigger, hypoglycemia is a rare cause of TTS.
• No prior reports exist of recurrent TTS specifically due to hypoglycemia.

Observation:

• A 51-year-old woman presented with impaired consciousness and shock, found to have severe hypoglycemia.
• Electrocardiogram and echocardiography confirmed TTS.
• The patient had a history of hypoglycemic coma and a previous ICU admission for TTS one year prior, linked to anorexia nervosa.

Findings:

• This is the first reported case of recurrent TTS triggered by hypoglycemia.
• The patient experienced repeated episodes of TTS associated with hypoglycemic coma secondary to anorexia nervosa.

Implications:

• Hypoglycemia can precipitate recurrent TTS, particularly in susceptible individuals.
• TTS should be considered in the differential diagnosis for patients with frequent hypoglycemia experiencing recurrent shock.
• Understanding this association is crucial for managing patients with both hypoglycemia and cardiac dysfunction.