Stress-Induced Cardiomyopathy Following Kidney Transplant

Takotsubo syndrome (TTS), commonly referred to as stress-induced cardiomyopathy, is a reversible type of nonischemic heart failure mimicking acute coronary syndrome.

A 55-year-old woman with end-stage renal disease experienced severe chest pain, dyspnea, and diaphoresis a few hours after undergoing a kidney transplant. Initial evaluations revealed ST-T wave changes alongside elevated troponin I levels. Echocardiography revealed a reduced left ventricular ejection fraction (LVEF) of 25% to 30% and apical wall motion abnormalities. Hence, coronary angiography was performed, which showed no significant coronary stenosis, a finding supporting a diagnosis of TTS. A follow-up transthoracic echocardiogram demonstrated a normalized LVEF 4 weeks later, thus confirming the provisional diagnosis.

This case highlights the necessity for clinicians to be vigilant for TTS in patients with acute cardiac conditions, specifically in patients undergoing significant physiological stress, such as post-surgery or following norepinephrine administration.