Key result
Severe hyperglycemia from undiagnosed type 2 diabetes triggers Takotsubo syndrome in an adolescent male.
Why the study?
Takotsubo syndrome in children is rare and typically linked to severe physiologic stressors, but atypical presentations and metabolic contributors are not well characterized.
Case Report (n=1)
This case demonstrates that Takotsubo syndrome can occur in adolescents following emotional stress without a classic physiologic stressor, highlighting the potential contributing role of underlying metabolic dysregulation such as untreated type 2 diabetes.
Should not change practice for adolescent chest pain; leaves open metabolic dysregulation as contributor to pediatric Takotsubo.
BACKGROUND: Takotsubo syndrome (TS) is a transient, nonischemic cardiomyopathy in children, typically associated with severe physiologic stressors. CASE SUMMARY: A 17-year-old boy presented with acute chest pain following emotional distress and exertion. Evaluation revealed ST-segment elevations, markedly elevated troponin levels, left ventricular apical wall motion abnormalities on echocardiography, and normal coronary angiography. Cardiac magnetic resonance imaging confirmed apical hypokinesis with myocardial edema and late gadolinium enhancement. He was also found to have severe hyperglycemia consistent with new-onset type 2 diabetes mellitus. DISCUSSION: This case highlights an atypical presentation of pediatric TS triggered by emotional stress and raises the possibility of metabolic dysregulation as a contributor. TAKE-HOME MESSAGES: TS, although rare in adolescents, can occur without a classic physiologic stressor, and untreated type 2 diabetes may represent a contributing factor. Cardiac magnetic resonance imaging plays a critical role in differentiating TS from alternative diagnoses and documenting myocardial recovery.
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Kash et al. (2026) conducted a case report in Takotsubo syndrome (n=1). Emotional distress and untreated type 2 diabetes was evaluated on Development of Takotsubo syndrome. A 17-year-old boy developed Takotsubo syndrome following emotional distress and exertion, with severe hyperglycemia suggesting untreated type 2 diabetes as a potential contributor.
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