Stress-Induced Cardiomyopathy After an Attempted Trigger-Point Injection

Stress-induced cardiomyopathy (SIC), also known as Takotsubo cardiomyopathy, resembles myocardial infarction with transient regional wall-motion abnormalities of the left ventricle and is often associated with physical or emotional stress. Unlike myocardial infarction, coronary angiography reveals no significant evidence of coronary artery disease or plaque rupture. The pathogenesis of SIC remains unclear, but it is proposed to be related to increased catecholamine release causing cardiotoxicity.

An 85-year-old woman presented with dizziness, nausea, and weakness immediately after an attempted trigger-point injection procedure. She was later found to have elevated cardiac markers and a negative coronary angiogram, and was subsequently diagnosed with SIC.

Increased awareness of SIC during common medical procedures may improve its recognition and underscore the importance of managing patients' procedural stress.