An unexpected cause of chronic cough in a young woman: Tachycardia-induced cardiomyopathy

Am J Emerg Med. 2019 Mar;37(3):563.e5-563.e7. doi: 10.1016/j.ajem.2018.12.014. Epub 2018 Dec 10.

Abstract

Heart failure typically manifests with exertional dyspnea or limb edema. Old age, underlying heart disease, and coronary risk factors are known risk factors for heart failure. Thus, congestive heart failure is rarely considered as a differential diagnosis of chronic cough in a previously healthy young person. However, tachycardia-induced cardiomyopathy (TIC) can result in such a situation. A case of a previously healthy 27-year-old woman with TIC is described herein. On the first examination, the patient presented with left ventricular (LV) dysfunction caused by persistent tachyarrhythmia. Cardiomyopathy subsided with only heart rate control; therefore, the patient was diagnosed as having TIC. TIC can develop irrespective of age and underlying heart disease. The long-term outcome may be good, and LV systolic function recovers in most patients following resolution of arrhythmia. Physicians need to consider TIC as a differential diagnosis in patients of any age who present with heart failure, because prompt treatment generally leads to resolution of symptoms and ventricular function.

Keywords: Congestive heart failure; Tachycardia-induced cardiomyopathy.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Cardiomyopathies / diagnosis*
  • Cardiomyopathies / drug therapy
  • Cardiomyopathies / etiology
  • Chronic Disease
  • Cough / etiology*
  • Diagnosis, Differential
  • Drug Therapy, Combination
  • Emergency Service, Hospital
  • Female
  • Heart Failure / diagnosis
  • Humans
  • Tachycardia / diagnosis*
  • Tachycardia / drug therapy
  • Tachycardia / physiopathology
  • Ventricular Dysfunction, Left / etiology