Tako-tsubo Cardiomyopathy Observed in a Patient With Sepsis and Transient Hyperthyroidism

Monaldi Arch Chest Dis. 2009 Mar;72(1):33-6. doi: 10.4081/monaldi.2009.341.

Abstract

A 55-years-old woman, with a history of hypertension and ischemic stroke with residual left hemiparesis, was admitted to our hospital because of dyspnoea with clinical evidence of acute pulmonary edema. She was found to have a sinus tachycardia with ST-elevation in leads D1, aVL and V1-V4 in the electrocardiogram, and akinesis of the left ventricular apex with overall left ventricular systolic function being severely impaired and an ejection fraction of 28% on echocardiography. Orotracheal intubation was performed and mechanical ventilation was immediately started. Emergency cardiac catheterization was performed 2 h after the symptom onset. Coronary angiography showed no significant coronary artery disease. Blood analysis revealed an increase in the creatine kinase MB fraction, a significant positive detection in troponin T, a white blood cell count of 35000 per microliter, C-reactive protein of 59,9 mg/dl, and transient elevation in the concentration of free triiodothyronine, free thyroxine, thyroid globulin antibody, and thyroid peroxidase antibody. The symptoms improved during the next days, and follow-up echocardiography 18 days later showed complete resolution of the left ventricular dysfunction. These data suggest that tako-tsubo cardiomyopathy may be induced in patients with sepsis and transient hyperthyroidism.

Publication types

  • Case Reports

MeSH terms

  • Amlodipine / therapeutic use
  • Anti-Bacterial Agents / therapeutic use
  • Antihypertensive Agents / therapeutic use
  • Antithyroid Agents / therapeutic use
  • Aspirin / therapeutic use
  • Echocardiography
  • Electrocardiography
  • Female
  • Glucocorticoids / therapeutic use
  • Humans
  • Hyperthyroidism / complications*
  • Hyperthyroidism / diagnosis*
  • Hyperthyroidism / drug therapy
  • Methimazole / therapeutic use
  • Middle Aged
  • Ofloxacin / therapeutic use
  • Platelet Aggregation Inhibitors / therapeutic use
  • Prednisone / therapeutic use
  • Propranolol / therapeutic use
  • Ramipril / therapeutic use
  • Sepsis / complications*
  • Sepsis / drug therapy
  • Takotsubo Cardiomyopathy / complications*
  • Takotsubo Cardiomyopathy / diagnosis*

Substances

  • Anti-Bacterial Agents
  • Antihypertensive Agents
  • Antithyroid Agents
  • Glucocorticoids
  • Platelet Aggregation Inhibitors
  • Amlodipine
  • Methimazole
  • Propranolol
  • Ofloxacin
  • Ramipril
  • Aspirin
  • Prednisone