Key result
A 90-year-old female with urosepsis developed Takotsubo cardiomyopathy with an initial ejection fraction of 35%-40%, which completely resolved to 60%-65% one month after antibiotic treatment.
Why the study?
Urosepsis-induced Takotsubo cardiomyopathy has rarely been reported in the literature.
Case Report (n=1)
This case highlights that physical stressors such as urosepsis can trigger Takotsubo cardiomyopathy, which should be considered in patients presenting with ACS-like symptoms and an underlying infection.
Highlights TCM as ACS mimic in nonagenarian; extends case literature but leaves open generalizability and management implications.
Takotsubo cardiomyopathy (TCM) is a rare but reversible myocardial left ventricular (LV) dysfunction, which mimics acute coronary syndrome (ACS) without the presence of significant coronary artery disease (CAD). Emotional stressors may include the death of kin or a life-threatening medical diagnosis whereas physical stressors include infections, endoscopic procedures, exacerbation of asthma, or systemic disorders. A 90-year-old female presented to the ED with nausea, intermittent chest heaviness, and generalized weakness for a duration of three days. Her troponin-I was elevated and an electrocardiogram (EKG) showed T-wave inversions in leads V2-V6 and no ST-segment changes. An echocardiogram (ECHO) revealed an ejection fraction (EF) of 35%-40% with anteroapical hypokinesis. She underwent cardiac catheterization showing nonobstructive CAD. She was diagnosed with pan-sensitive Escherichia coli urosepsis and started on ceftriaxone. She improved clinically and was discharged. A repeat ECHO done a month later showed normal EF. Urosepsis-induced TCM has rarely been reported in the literature. Physicians should have a high index of suspicion of TCM in patients with symptoms mimicking ACS in the presence of a physical stressor like an infection. We report the case of TCM, which resulted from a urinary tract infection (UTI) in an elderly female.
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Sendil et al. (2020) conducted a case report in Takotsubo cardiomyopathy and urosepsis (n=1). Urosepsis was evaluated on Left ventricular ejection fraction recovery. A 90-year-old female with urosepsis developed Takotsubo cardiomyopathy with an initial ejection fraction of 35%-40%, which completely resolved to 60%-65% one month after antibiotic treatment.
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