, Volume 101, Issue 11, pp 939-940
Date: 09 May 2012

Fatal stress-induced cardiomyopathy in a young patient treated with adrenomimetics

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Sirs:

Stress-induced cardiomyopathy (SIC), also known as Takotsubo cardiomyopathy, is characterized by potentially reversible extensive left ventricular (LV) akinesia. The typical presentation is that of an akinetic ballooning apex with hypercontractile basal segments. Post-menopausal women are the typical patients [1]. Excessive levels of catecholamines are believed to directly or indirectly cause cardiac dysfunction [2] and exogenously administered β-mimetics may trigger SIC [3]. Extrapolation of positive inotropic treatment strategies used in other forms of acute heart failure to SIC may therefore provide an additional catecholamine load on the heart and may be detrimental.

We present a fatal case of stress-induced cardiomyopathy in an 18-year-old man with Aspergers syndrome in whom the cardiac dysfunction may have been iatrogenically exacerbated by repeated administration of inotropic agents.

The patient was found unconscious and hypothermic in the vicinity of a demolished car 1 day a ...