Extracorporeal Cooling in Heat Stroke Induced Takotsubo Cardiomyopathy

Heat stroke is a life-threatening condition characterized by elevated core body temperature (≥ 40°C) and central nervous system (CNS) dysfunction, resulting from body's inability to adequately dissipate heat. It can lead to multiorgan failure, including the cardiovascular system. Takotsubo cardiomyopathy (TCM), also known as stress-induced cardiomyopathy, is an acute syndrome of transient global or regional ventricular dysfunction, most commonly apical ballooning, mimicking acute coronary syndrome, typically occurring after severe physical or emotional stress. Although individually well-described, the combination of severe heat stroke as a trigger for TCM is rare. This case report describes a female patient with severe heat stroke who developed TCM and, due to persistent hyperthermia unresponsive to conventional cooling methods, was successfully cooled using prolonged intermittent hemodiafiltration. It also highlights the importance of timely recognition of atypical complications such as TCM in patients with cardiovascular instability and demonstrates the potential role of hemodialysis as an effective cooling method in cases of refractory hyperthermia.