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Colegio de Medicina Interna de México.

2017, Number 3

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Med Int Mex 2017; 33 (3)

Takotsubo cardiomyopathy secondary to sepsis. A little frequent association

Carrillo-Esper R, Rosado-Garduño P, Ramírez-Ambriz PM, Sánchez-Zúñiga MJ

Language: Spanish
References: 75
Page: 427-435
PDF size: 470.70 Kb.


ABSTRACT

Takotsubo cardiomyopathy (TC) is characterized by transient left ventricular apical wall motion abnormalities, chest pain with electrocardiographic changes and increased myocardial enzymatic release mimicking acute coronary syndrome, but without significant coronary artery disease. It is usually precipitated by acute emotional or physical stressors, such as subarachnoid haemorrhage, traumatic brain injury or sepsis. The pathogenetic mechanism is related to catecholamine cardiomyopathy, rendering TC a type of neurocardiological disorder manifested as acute but reversible heart failure. A case example is described in which a 80 year-old woman with sepsis secondary to pneumonia developed suddenly left cardiac failure, lung edema, increased cardiac enzymes and ST-segment and T wave alterations. A left ventriculogram showed severe apical hipokinesis, a normal anterobasal segment motion without coronary artery obstruction. Intensivists should consider this syndrome in the differential diagnosis of septic patients presenting with clinical findings suggestive of acute coronary syndrome.


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