Tako-tsubo syndrome after administration of intravenous adrenaline during atrioventricular block

Abstract

We describe the clinical case of a 70-year-old woman with complete atrioventricular block that after administration of intravenous adrenaline, developed electrocardiographic changes suggestive of acute coronary syndrome, together with apical dyskinesia of the left ventricle. After ruling out the existence of coronary lesions, and after total recovery of the echocardiographic alterations in segmental contractility, she was diagnosed as Tako-tsubo syndrome induced by administration of adrenaline. This is the first report of this syndrome in the scenario of atrioventricular block treated with adrenaline infusion.

Takotsubo cardiomyopathy with severe bradyarrhythmia following epidural insertion

“…In our case, it is possible that the administration of epinephrine during the brief cardiac arrest may have contributed to the development of TTC as this mechanism has been previously suggested. 9 The correct management of TTC with complete AV block is uncertain and can be challenging. Literature on this subject is limited but recent studies have suggested that AV block persists despite resolution of the cardiomyopathy, and that permanent pacemaker implantation improves mortality in these patients.…”