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When a Tooth Pulls the Heart Strings: Takotsubo Cardiomyopathy Post-dental Extraction
Muhammad Adil Afzal1, Sacide S Ozgur1, Yezin Shamoon2
1Internal Medicine, St. Joseph's University Medical Center, Paterson, USA.
Cureus
|August 21, 2023
Summary
Takotsubo cardiomyopathy, or stress-induced cardiomyopathy, can occur after dental procedures. This case highlights its occurrence in a postmenopausal woman following tooth extraction, emphasizing stress as a trigger.
Area of Science:
- Cardiology
- Internal Medicine
Background:
- Takotsubo cardiomyopathy (TTC), or stress-induced cardiomyopathy, is a transient left ventricular dysfunction.
- It is typically triggered by a catecholamine surge during severe emotional or physical stress.
Observation:
- A 59-year-old postmenopausal woman presented with chest pain post-dental extraction.
- Initial ECG and cardiac enzymes suggested cardiac injury, necessitating cardiac catheterization.
- Catheterization revealed normal coronary arteries but showed left ventricular apical ballooning.
Findings:
- Transthoracic echocardiogram confirmed TTC, showing septal hypertrophy, reduced ejection fraction, and apical akinesis.
- This case represents secondary TTC triggered by the stress of a dental procedure for a periapical abscess.
Implications:
- This case underscores the potential for stress-induced cardiomyopathy in postmenopausal women, even after minimally invasive procedures.
- Undiagnosed anxiety disorders may increase susceptibility.
- Highlights the importance of considering TTC in patients presenting with chest pain post-stressful events.
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