TY - JOUR
T1 - Takotsubo cardiomyopathy in a chronic spinal cord injury patient with autonomic dysreflexia
T2 - A case report
AU - Pollifrone, Maria
AU - Sikka, Seema
AU - Hamilton, Rita
N1 - Publisher Copyright:
© The Academy of Spinal Cord Injury Professionals, Inc. 2020.
PY - 2021
Y1 - 2021
N2 - 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.
AB - 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.
KW - Autonomic dysreflexia
KW - Cardiac monitoring
KW - Chronic spinal cord injury
KW - Takotsubo cardiomyopathy
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U2 - 10.1080/10790268.2020.1724355
DO - 10.1080/10790268.2020.1724355
M3 - Article
C2 - 32043945
AN - SCOPUS:85079402630
SN - 1079-0268
VL - 44
SP - 1026
EP - 1029
JO - Journal of Spinal Cord Medicine
JF - Journal of Spinal Cord Medicine
IS - 6
ER -