This case demonstrates that an exogenous catecholamine surge from a noradrenaline bolus can induce reversible inverted tako-tsubo cardiomyopathy.
Noradrenaline bolus may precipitate inverted tako-tsubo cardiomyopathy; leaves open causality and generalizability beyond this case.
Inverted tako-tsubo cardiomyopathy (TTC) is a variation of stress cardiomyopathy. It features transient myocardial dysfunction characterised by a typical contractile abnormality consisting of extensive left ventricular circumferential dyskinesia or akinesia with a hyperkinetic apex. Endogenous catecholamine surges are believed to be the mediators of this potentially life-threatening condition. We describe a patient who received an inadvertent bolus of noradrenaline and developed significant haemodynamic instability associated with electrocardiographic and cardiac biomarkers indicative of diffuse myocardial injury and echocardiography findings of an "inverted" TTC. The patient made a full recovery. Our case highlights that a reversible inverted TTC may result from an exogenous catecholamine surge.
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Subramaniam et al. (2010) studied this question.
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