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Case Reports
. 2016 Jul;8(7):316-9.
doi: 10.4103/1947-2714.187156.

Clostridium Difficile Infection and Takotsubo Cardiomyopathy: Is There a Relation?

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Free PMC article
Case Reports

Clostridium Difficile Infection and Takotsubo Cardiomyopathy: Is There a Relation?

Hafeez Ul Hassan Virk et al. N Am J Med Sci. .
Free PMC article

Abstract

Context: Takotsubo cardiomyopathy (TCM) mimics acute coronary syndrome and is accompanied by reversible left ventricular apical ballooning in the absence of angiographically significant coronary artery stenosis. It is a transient condition that typically precedes physical or emotional triggers.

Case report: We describe the case of a 65-year-old woman who presented to our institution with symptomatic Clostridium difficile infection. 24 hours after admission, the patient complained of severe, retrosternal chest pain. Electrocardiogram showed diffuse elevation of ST-segment in the chest leads; however, coronary angiography demonstrated normal coronary arteries. Therein, an echocardiography was performed, which revealed apical ballooning and hypercontractile base with global left ventricular hypokinesis. These features were consistent with TCM. The patient was managed conservatively. Repeat echocardiogram 2 weeks later showed resolution of heart failure.

Conclusion: To our research, this is the first report of TCM caused by C. difficile infection. Clinicians involved in the care of patients with C. difficile infection must be aware of this complication and should consider TCM in those who develop atypical chest pain.

Keywords: Apical ballooning; Clostridium difficile; coronary artery disease; takotsubo cardiomyopathy.

Figures

Figure 1
Figure 1
Electrocardiogram showing diffuse elevation of ST segment in the chest leads
Figure 2
Figure 2
Transthoracic echocardiogram demonstrating apical ballooning and hypercontractile base
Figure 3
Figure 3
Left ventriculography demonstrating reduced left ventricle ejection fraction and apical ballooning consistent with Takotsubo cardiomyopathy
Figure 4
Figure 4
Transthoracic echocardiogram 2 weeks after discharge demonstrating normal left ventricle ejection fraction with no wall motion abnormalities

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References

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