Key result
Beta-blockers and anti-failure medications restore LVEF to 65% in a male with stress-induced sinus tachycardia.
Why the study?
Tachycardia-induced cardiomyopathy is a reversible myocardial dysfunction caused by tachyarrhythmias, making it essential to identify arrhythmias in patients presenting with unexplained myocardial dysfunction.
Does heart rate control with beta-blockers and anti-failure therapy improve left ventricular function in a patient with stress-induced sinus tachycardia cardiomyopathy?
Case Report (n=1)
No
Does heart rate control with beta-blockers and anti-failure therapy improve left ventricular function in a patient with stress-induced sinus tachycardia cardiomyopathy?
Prolonged stress-induced sinus tachycardia can cause reversible tachycardia-induced cardiomyopathy, which can be successfully treated and prevented with beta-blockers and heart rate control.
Supports beta-blocker therapy for reversible stress tachycardia cardiomyopathy; leaves open need for prospective trials before broader adoption.
Background: Tachycardia-induced cardiomyopathy (TCM) is a reversible form of myocardial dysfunction because of tachyarrhythmias. Therefore, it is essential to identify arrhythmias in patients presenting with myocardial dysfunction without apparent aetiology. Case: Herein, we present a thirty-seven-year-old male with bouts of prolonged sinus tachycardia and severe mental stress, averaging >130 beats per minute, before abdominal operations more than once in a few months. A notably dynamic ventricular stunning was noted that partially normalized in a few days, once relieving relieving tension and reduced heart rate. Complete normalization of ventricular function was observed after five months of maintaining the average heart rate. Initially, the present case was missed due to its paroxysmal nature. Later, the patient was cured with a maximum tolerated dose of beta-blockers, anti-failure, and small doses of anxiolytic agents. Our case is a rare case report of recurrent TCM the same patient due to episodes of marked sinus tachycardia. Conclusion: Sinus tachycardia is often considered a physiological response to mental stress that may cause cardiac injury related to a prolonged stress response. Treatment of stress sinus tachycardia-induced cardiomyopathy (sinus tachycardia-ICM) leads to recovery of myocardial function. The literature does not recommend controlling heart rates in patients with persistent sinus tachycardia preoperatively, but it is a therapeutic option for preparing patients for operation. Successfully, beta-blockers were used in our patient and should be considered in similar case scenarios.
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Shawky et al. (2022) conducted a case report in Sinus tachycardia-induced cardiomyopathy (n=1). Beta-blockers, anti-failure medications, and anxiolytics was evaluated on Left ventricular ejection fraction (LVEF). Treatment of stress-induced sinus tachycardia with beta-blockers and anti-failure medications led to complete recovery of left ventricular systolic function (LVEF 65%) in a 37-year-old male.
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