Key result
Active cooling and cooled IV fluids improve cardiovascular status in severe heatstroke with Takotsubo cardiomyopathy.
Why the study?
Heatstroke and Takotsubo cardiomyopathy can share the same pathophysiology, but clinical reports detailing this complication are limited.
Case Report (n=1)
No
Severe heatstroke can be complicated by Takotsubo cardiomyopathy, highlighting the critical need for close evaluation of hemodynamic status and myocardial damage.
Heatstroke may mimic STEMI on EKG; leaves open whether urgent angiography is warranted before cooling in febrile coma.
Case: A 69 year-old female with history of schizophrenia was transported to our hospital by ambulance due to coma. On arrival, she was hypotensive and tachycardic with a Glasgow coma scale score of 3 and a rectal core temperature of 40°C. Heatstroke was strongly suspected as the cause of the coma and hypotension. Active external cooling with an electric fan and cooled IV fluid administration were started. Her electrocardiogram (EKG) showed ST elevation in V2-6, II, III and aVF. Echocardiography revealed apical ballooning, which indicated Takotsubo cardiomyopathy. Coronary angiography indicated normal coronary arteries. Outcome: After admission to the intensive care unit, her cardiovascular status gradually improved and she was transferred to the psychiatric ward on day 36. Conclusion: Heatstroke and Takotsubo cardiomyopathy can share the same pathophysiology. Close evaluation of hemodynamic status and myocardial damage is critical for survival.
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Tada et al. (2015) conducted a case report in Severe heatstroke and Takotsubo cardiomyopathy (n=1). Active external cooling and cooled IV fluid administration was evaluated on Cardiovascular status improvement and survival. Active external cooling and cooled IV fluid administration led to gradual improvement of cardiovascular status in a patient with severe heatstroke complicated by Takotsubo cardiomyopathy.
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