TITLE:
Variant of takotsubo cardiomyopathy associated with sepsis and respiratory failure in an elderly female
AUTHORS:
Punnaiah Marella, Shantipriya Siripurapu, Hassan Hussein, Rajeev Garg
KEYWORDS:
Takotsubo Cardiomyopathy; Inverted Cardiomyopathy; Stress Induced Cardiomyopathy
JOURNAL NAME:
World Journal of Cardiovascular Diseases,
Vol.3 No.1,
January
14,
2013
ABSTRACT: Stress induced cardiomyopathy/Takotsubo
cardiomyopathy (TSO CMO) has been widely reported. It is characterized by apical
hypokinesis or akinesis. Variants of this called as inverted/reverse cardiomyopathies have been reported and are characterized by basal hypokinesis/akinesis and hypercontractility
of apex. These are more common in younger population. We present an elderly female
who had a variant cardiomyopathy in association with sepsis and respiratory failure
and this has been rarely reported. An 84 year old female presented with cough, dyspnea
and fevers. She was treated for pneumonia but her respiratory failure worsened and
she suffered a non ST segment elevation myocardial infarction. Cardiac catheterization revealed normal coronaries but ejection fraction was low at 25% with basal
hypokinesis and a hyperkinetic apex. She improved with diuresis and medical management
of a variant of stress induced cardiomyopathy. Stress induced cardiomyopathies
and its variants are reversible conditions and improve with conservative management.
These entities should be kept in mind during investigation of any acute myocardial
infarction.