An Unusual Trigger for Stress Cardiomyopathy

Abstract

Our patient is a 65-year-old male with a history of hypertension, hyperlipidemia, diabetes mellitus, alcohol abuse and paroxysmal atrial fibrillation, who presented to the emergency department with epigastric pain. On laboratory examination, his sodium level was found to be 127 meq/L (normal range: 136 - 145 meq/L). During his hospital course, he developed retrosternal chest pain. His electrocardiogram (ECG) during this episode showed deep symmetrical T wave inversions in the anterior, septal and apical leads. His symptoms of chest pain and ECG changes prompted a cardiac catheterization, which revealed, non-obstructive coronary disease with left ventriculogram significant for apical near akinesis and preserved basal wall motion, characteristic findings of Takotsubo cardiomyopathy, with an estimated left ventricle ejection fraction of 35-40%.




J Med Cases. 2018;9(12):386-389
doi: https://doi.org/10.14740/jmc3132w