Atypical Stress Induced Cardiomyopathy During Endoscopic Sinus Surgery With Septoplasty in an Elderly Male Patient

Abstract

Stress-induced cardiomyopathy, also known as Takotsubo cardiomyopathy, is caused by emotional or physical stressors and mimics acute myocardial infarction. Stress-induced cardiomyopathy is characterized by acute, reversible left ventricular apical ballooning without significant coronary artery stenosis. New variants of stress-induced cardiomyo pathy with localized wall motion abnormalities or an inverted pattern with a hyperdynamic apex have been reported. We present a rare case of a sudden cardiac arrest due to atypical stress-induced cardiomyopathy (mucosal packing and the injection of epinephrine) in an elderly male patient during elective endoscopic sinus surgery with septoplasty under local anesthesia. In this case, only the basal and midportions of the left ventricle were affected, whereas the apex was completely spared. The patient rapidly and completely recovered without sequelae.

Stress Cardiomyopathy due to Misuse of TransdermalFentanyl Patches in an Elderly Patient

“…Stress cardiomyopathy is characterized by transient, regio-nal systolic dysfunction of the left ventricle without obstructive epicardial coronary artery disease. It predominantly affects postmenopausal women and is frequently, though not always, triggered by an acute medical illness or an intense emotional or physical stress 1,2,4,5) .…”