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Abstract

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Article in Japanese

Case Report

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

ABSTRACT

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.

KEYWORDS

Bronchial asthma  Takotsubo cardiomyopathy  β2 stimulant  Epinephrine 

Received 6 Dec 2017 / Accepted 20 Feb 2018

AJRS, 7(3): 177-181, 2018

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