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Article in Japanese
Takotsubo cardiomyopathy following treatment for an asthma attack: a case report
Mitsutoshi Sugiyama Yukihiro Umeda Akikazu Shimada Miho Mitsui Miwa Morikawa Tamotsu Ishizuka
Third Department of Internal Medicine, Faculty of Medical Sciences, University of Fukui
A 73-year-old female with atopic asthma, who was prescribed daily administration of an inhaled and oral short-acting β2 agonist (SABA), had a sudden-onset severe asthma exacerbation. Her condition deteriorated to include wheezing and dyspnea, and she was taken by ambulance to a nearby hospital. SABA nebulizer was given, epinephrine (0.2mg) was subcutaneously injected twice, and intravenous hydrocortisone was also administered. Following admission, dyspnea worsened and an electrocardiogram revealed negative T waves in I, II, aVf, and V3–V6. Furthermore, echocardiography demonstrated apical dyskinesia, and creatinine kinase levels were found to be mildly elevated. After treatment for the asthma attack, the patient was diagnosed with Takotsubo cardiomyopathy. In the present case, we speculate that Takotsubo cardiomyopathy was triggered by a SABA overdose and the subcutaneous injection of epinephrine, as well as by the severe asthma attack itself. Physicians should keep in mind that Takotsubo cardiomyopathy is a possible complication of an asthma attack and the associated treatment.
Bronchial asthma Takotsubo cardiomyopathy β2 stimulant Epinephrine
Received 6 Dec 2017 / Accepted 20 Feb 2018
AJRS, 7(3): 177-181, 2018