Biventricular Stress Cardiomyopathy Triggered by Hanging: A Rare Clinical Manifestation in a Young Female

Stress-induced cardiomyopathy (SIC) is an uncommon but reversible form of acute myocardial dysfunction that may occur following severe physical or emotional stress. Although typically reported in older adults, SIC can also develop in adolescents exposed to extreme stressors such as suicidal hanging. We report the case of a 16-year-old previously healthy female who presented in an unresponsive state following a hanging attempt. She exhibited profound hypoxia, hypotension, and reduced sensorium requiring intubation and vasopressor support. Initial imaging, including computed tomography (CT) brain and CT angiography of the neck vessels, revealed no structural injury. Echocardiography performed on day 1 demonstrated biventricular apical hypokinesia with preserved basal contractility, consistent with a biventricular variant of stress cardiomyopathy. Cardiac biomarkers were markedly elevated. The patient showed rapid clinical improvement with supportive management, with near normalization of ventricular function on serial echocardiography. This case highlights the need for early cardiac evaluation in survivors of hanging, particularly in adolescents.