Case of Reverse Takotsubo Cardiomyopathy in Status Asthmaticus

Stanojević, Dušan; Alla, Venkata; Lynch, Joseph D.; Hunter, Claire

doi:10.1097/smj.0b013e3181eb349d

Cited by 13 publications

(5 citation statements)

References 5 publications

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“…To our knowledge, there were only 5 similar cases reported in literature [ 3 – 7 ]. Although our patient presented with asthma exacerbation which may count as an acute stressor, there was no evidence of severe stress as in status asthmaticus or respiratory failure as previously reported in two cases [ 5 , 6 ]. The likely mechanism of TCM in our case is mediated through the β agonist action of albuterol.…”

Section: Discussionsupporting

confidence: 52%

Takotsubo Cardiomyopathy: A New Perspective in Asthma

Marmoush

Barbour

Noonan

et al. 2015

Case Reports in Cardiology

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Takotsubo cardiomyopathy (TCM) is an entity of reversible cardiomyopathy known for its association with physical or emotional stress and may mimic myocardial infarction. We report an exceedingly rare case of albuterol-induced TCM with moderate asthma exacerbation. An interesting association that may help in understanding the etiology of TCM in the asthmatic population. Although the prognosis of TCM is excellent, it is crucial to recognize beta agonists as a potential stressor.

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Section: Discussionsupporting

confidence: 52%

Takotsubo Cardiomyopathy: A New Perspective in Asthma

Marmoush

Barbour

Noonan

et al. 2015

Case Reports in Cardiology

View full text Add to dashboard Cite

show abstract

“…Other studies have also shown stress cardiomyopathy in the setting of an acute asthma exacerbation or after repeated use of beta2-agonist inhalation [10][11][12][13][14][15][16][17]. Most of the cases involved elderly women with a history of asthma presenting with dyspnea rather than chest pain [12][13][14][15][16][17][18][19]. Only 1 case involved a male patient who presented with asthma exacerbation complicated with stress cardiomyopathy after frequent inhalation of steroids and long acting beta2-agonist [17].…”

Section: Discussionmentioning

confidence: 99%

Rare Association of Takotsubo Cardiomyopathy with Right Bundle Branch Block in the Dual Setting of Asthma Exacerbation and Psychiatric Illness

et al. 2020

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Rare co-existance of disease or pathology Background: Takotsubo cardiomyopathy is characterized by a transient left ventricular dysfunction without obstructive coronary artery disease that mimics an acute myocardial infarction. The electrocardiogram findings of Takotsubo cardiomyopathy usually present with ST-segment elevation or depression, T-wave inversion, left bundle branch block or high-grade atrioventricular block. Case Report: This is a report of a case of a 58-year-old male diagnosed with Takotsubo cardiomyopathy that occurred in the setting of an acute asthma exacerbation and psychiatric exacerbation with novel electrocardiogram findings of right bundle branch block. Transthoracic echocardiogram showed a preserved ejection fraction with left ventricular apical ballooning and hyperkinesis of the basal segments. The nuclear stress test showed a fixed perfusion defect at the apical segment, but the patient refused further testing such as coronary angiography. The patient was managed medically, and a repeat echocardiogram done after 8 weeks from discharge showed a complete resolution of the apical ballooning. Conclusions: It is important to recognize that patients with psychiatric illness and asthma exacerbation are predisposed to develop Takotsubo cardiomyopathy. It is also reasonable to suspect Takotsubo cardiomyopathy in the presence of new electrocardiogram findings aside from those typically seen in acute myocardial infarction, especially if it is associated with apical ballooning.

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“…Stanojevic et al reported the first case of TCM associated with status asthmaticus. In their case, they reported an excessive amount of albuterol inhaler use by the patient [ 15 ]. Although it is very difficult to ascertain an independent role of beta-2 agonists in the development of TCM, the association is being increasingly recognized [ 14 , 15 ].…”

Section: Discussionmentioning

confidence: 99%

Repeated use of albuterol inhaler as a potential cause of Takotsubo cardiomyopathy

et al. 2014

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Patient: Female, 78Final Diagnosis: Takotsubo cardiomyopathySymptoms: Chest discomfort, chest pain, dyspnea, short of breathMedication: —Clinical Procedure: —Specialty: CardiologyObjective:Unusual or unexpected effect of treatmentBackground:Takotsubo cardiomyopathy is an increasingly recognized cardiac condition that usually results from an acute stressor. Some medications are becoming recognized as possible stressors. Albuterol is widely used in general medicine. We report an unusual link between Takotsubo cardiomyopathy and albuterol.Case Report:A 78-year-old woman presented to our emergency department for chest pain of 2-day duration. The patient had been taking albuterol inhaler therapy for worsening shortness of breath followed by chest pain. Her albuterol use was excessive. There were no other acute stressors. The electrocardiogram showed ST-elevations in the anterior and inferior leads. Emergent coronary angiography showed noncritical coronary artery disease and left ventriculography showed apical ballooning.Conclusions:When patients taking albuterol present with acute chest pain in the absence of other etiologies, beta-agonist-induced Takotsubo cardiomyopathy should be considered.

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Case of Reverse Takotsubo Cardiomyopathy in Status Asthmaticus

Cited by 13 publications

References 5 publications

Takotsubo Cardiomyopathy: A New Perspective in Asthma

Takotsubo Cardiomyopathy: A New Perspective in Asthma

Rare Association of Takotsubo Cardiomyopathy with Right Bundle Branch Block in the Dual Setting of Asthma Exacerbation and Psychiatric Illness

Repeated use of albuterol inhaler as a potential cause of Takotsubo cardiomyopathy

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