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A Case Of Takotsubo Syndrome Precipitated By Diabetic Ketoacidosis
Anawin T Kitpowsong1, Haris Muhammad2, Sarah Aftab Ahmad3
1Edward Via College of Osteopathic Medicine, Monroe, LA, USA.
Insights
Takotsubo syndrome (TTS), a form of stress-induced cardiomyopathy, can mimic heart attacks. This case highlights TTS triggered by diabetic ketoacidosis (DKA) in an elderly diabetic patient.
Area of Science:
- Cardiology
- Endocrinology
Background:
- Takotsubo syndrome (TTS), also known as stress-induced cardiomyopathy, presents as transient left ventricular dysfunction mimicking acute coronary syndrome (ACS) but without obstructive coronary artery disease.
- TTS predominantly affects postmenopausal women and is typically triggered by significant physical or emotional stress, though rare associations with conditions like diabetic ketoacidosis (DKA) exist.
Observation:
- This report details an elderly female with type II diabetes mellitus (DM) who developed TTS upon admission for DKA.
Findings:
- The patient's TTS symptoms resolved following successful treatment of DKA and initiation of standard heart failure therapies.
Implications:
- This case underscores the importance of considering TTS in patients with DKA, particularly those with underlying diabetes mellitus.
- It suggests that prompt management of the precipitating metabolic derangement (DKA) may be crucial for TTS resolution in this patient population.
Abstract:
Takotsubo syndrome (TTS), Takotsubo cardiomyopathy, or stress-induced cardiomyopathy are interchangeable terms characterized by transient left ventricular systolic dysfunction, electrocardiographic changes, and cardiac biomarker elevation similar to acute coronary syndrome (ACS), without the presence of obstructive epicardial coronary artery disease. It predominantly affects postmenopausal females and manifests in the presence of stressful triggers such as severe physical or emotional stress, natural disasters, unexpected death of relatives, acute medical illnesses, etc. TTS was initially considered to be a benign condition however recent studies have shown that it may be associated with complications and mortality similar to ACS. Rare reports of TTS triggered by diabetic ketoacidosis (DKA) have been published. Herein we describe a case of an elderly female with a history of type II diabetes mellitus (DM) who was admitted with DKA and subsequently developed TTS that resolved after treatment of DKA and implementation of heart failure therapies.
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