Takotsubo cardiomyopathy in a chronic spinal cord injury patient with autonomic dysreflexia: A case report

Maria Pollifrone, Seema Sikka, Rita Hamilton

Research output: Contribution to journalArticlepeer-review

Abstract

Context: Takotsubo cardiomyopathy (TC) is a transient stress-induced cardiomyopathy with left ventricular dysfunction of unknown etiology. A well accepted theory for the pathophysiology of TC is attributed to a massive catecholamine release [1]. This case report will review a chronic tetraplegia patient who was diagnosed with TC after a severe episode of autonomic dysreflexia (AD). He experiences mild episodes of AD several times a day; however, he had never experienced the severity of symptoms that was associated with this episode which led to his hospitalization. Autonomic dysreflexia is a syndrome of imbalanced sympathetic input secondary to loss of descending central sympathetic control in spinal cord injury due to noxious stimuli below the level of the injury, which occurs when the injury level is at thoracic level 6 (T6) or above [2]. Findings: In this specific case, it is presumed that the massive catecholamine release associated with this severe AD episode resulted in TC. Although TC has been diagnosed after other instances of acute stress, it is unknown for it to be diagnosed after AD in a chronic setting. Clinical Relevance: The long-term effects of AD have not been well studied, and this case illustrates the importance of education to recognize and manage AD in the spinal cord patient who frequently has episodes of AD.

Original languageEnglish (US)
Pages (from-to)1026-1029
Number of pages4
JournalJournal of Spinal Cord Medicine
Volume44
Issue number6
DOIs
StatePublished - 2021
Externally publishedYes

Keywords

  • Autonomic dysreflexia
  • Cardiac monitoring
  • Chronic spinal cord injury
  • Takotsubo cardiomyopathy

ASJC Scopus subject areas

  • Clinical Neurology

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