Key result
Carbon monoxide poisoning combined with emotional stress triggers Takotsubo syndrome with full 1-month recovery.
Why the study?
Carbon monoxide poisoning has not yet been described as a trigger for Takotsubo syndrome despite its potential to cause severe cardiac injury.
Case Report (n=1)
No
Carbon monoxide poisoning combined with emotional stress may act as a novel trigger for Takotsubo syndrome, likely via a catecholamine surge.
CO poisoning with stress may trigger Takotsubo syndrome; this case leaves open causality and generalizability.
Introduction: Carbon monoxide (CO) is a leading cause of poisoning worldwide.Central nervous systems and the heart have the highest demand for oxygen and may be severely injured in CO poisoning. Case report: A patient was referred to the emergency department after exposure to CO and strong emotional stress. On admission she was comatose with elevated lactate 14,62, metHgb 0,3% and carboxyhemoglobin 12,9%. Electrocardiogram showed sinus rhythm, 100 beats/min, poor R wave progression with inverted T waves in V1-V3 leads, biphasic T waves in V5 and V6. Transthoracic echocardioography showed left ventricle with akinetic apex and all apical segments of the left ventricle with reduced systolic function. Cardiac troponin was significantly elevated; coronary angiography showed normal coronary arteries without culprit lesion. Takotsubo syndrome was diagnosed. She was treated with high flow oxygen on mechanical ventilation, antiplatelet, angi-otenzinconvertase inhibitors, beta blockers and statin therapy with complete recovery. After one month ehocardiography showed left ventricle normal in size and function. Conclusion: CO poisoning hasn't yet been described as a trigger for Takotsubo syndrome. We propose that two risk factors CO poisoning and stress by may have initiated a catecholamine surge and caused the development of this specific condition.
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Miljković et al. (2018) conducted a case report in Carbon monoxide poisoning and Takotsubo syndrome (n=1). Carbon monoxide poisoning and emotional stress was evaluated on Development of Takotsubo syndrome. Carbon monoxide poisoning combined with emotional stress triggered the development of Takotsubo syndrome in a 39-year-old woman, which completely resolved after one month.
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