COVID-19 is a serious disease with high morbidity and mortality around the globe. We present a case of a 45-year-old male who presents with substernal chest pain three days after receiving the second dose of his COVID-19 mRNA (Moderna) vaccine. A transthoracic echo showed reduced left ventricular ejection fraction of 25-30% with akinesis of the mid to distal anterior, anteroseptal, anterolateral, inferolateral, inferoseptal, and inferior walls. Patient symptoms improved significantly during his hospitalization. Repeat trans-thoracic echo four days after his hospitalization showed ejection fraction recovery without segmental wall motion abnormalities. This case demonstrates the importance of recognizing Takotsubo cardiomyopathy as a complication of COVID-19 vaccine.
Stress cardiomyopathy (SCM) occurs in approximately 1% of patients presenting with troponin-positive suspected acute coronary syndrome (ACS). We present here a 50-year-old female who presented to the emergency department (ED) with altered mental status. In the hospital, she was found to have status epilepticus (SE) secondary to Herpes simplex virus encephalitis. Her hospital stay was complicated by high troponins and a transthoracic echocardiogram showed reduced ejection fraction and wall motion abnormality. Repeat echo five days later showed normal ventricular systolic function with no wall motion abnormality. Extensive ischemia workup was negative. A diagnosis of stress cardiomyopathy has been made. We urge physicians to include SCM in their differential diagnosis especially in cases of status epilepticus in order to avoid invasive procedures and for better management of patients.
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