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Post-Anaphylaxis Adrenaline-Induced Takotsubo Cardiomyopathy: A Case Report
Zahid Khan1,2,3,4, Fady Eldabe2, Konstantinos Tyrovolas2
1Acute Medicine, Mid and South Essex NHS Foundation Trust, Southend-on-Sea, GBR.
Cureus
|June 24, 2025
Summary
Takotsubo cardiomyopathy (TCM) can be triggered by adrenaline administration for anaphylaxis. This case study shows reversible left ventricular dysfunction after epinephrine treatment for a pistachio allergy.
Area of Science:
- Cardiology
- Allergology
- Pharmacology
Background:
- Takotsubo cardiomyopathy (TCM) is an acute, reversible heart condition.
- It is characterized by left ventricular apical ballooning without coronary obstruction.
- The pathophysiology is linked to stress-induced adrenaline release.
Observation:
- A 71-year-old female presented with anaphylaxis symptoms after pistachio consumption.
- She received intramuscular adrenaline for a delayed allergic reaction.
- Within minutes, she developed chest pain and ECG changes consistent with myocardial infarction.
Findings:
- Coronary angiography revealed no obstructions.
- Echocardiography showed left ventricular apical ballooning and mild systolic dysfunction.
- These findings were consistent with TCM secondary to adrenaline administration.
Implications:
- This case highlights a potential trigger for TCM: adrenaline used to treat anaphylaxis.
- It underscores the importance of considering TCM in patients with cardiac symptoms post-epinephrine.
- Prompt diagnosis and management, including beta-blocker therapy, can lead to full recovery.
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