J Korean Geriatr Soc.  2013 Dec;17(4):219-222. 10.4235/jkgs.2013.17.4.219.

Atypical Stress Induced Cardiomyopathy During Endoscopic Sinus Surgery With Septoplasty in an Elderly Male Patient

• Lee HS
• Yi JR
• Jung YN
• Jo GH
• Sir JJ
• Choi SM

• KMID: 2188231
• DOI: http://doi.org/10.4235/jkgs.2013.17.4.219

Abstract

Stress-induced cardiomyopathy, also known as Takotsubo cardiomyopathy, is caused by emotional or physical stressors and mimics acute myocardial infarction. Stress-induced cardiomyopathy is characterized by acute, reversible left ventricular apical ballooning without significant coronary artery stenosis. New variants of stress-induced cardiomyo pathy with localized wall motion abnormalities or an inverted pattern with a hyperdynamic apex have been reported. We present a rare case of a sudden cardiac arrest due to atypical stress-induced cardiomyopathy (mucosal packing and the injection of epinephrine) in an elderly male patient during elective endoscopic sinus surgery with septoplasty under local anesthesia. In this case, only the basal and midportions of the left ventricle were affected, whereas the apex was completely spared. The patient rapidly and completely recovered without sequelae.

Keyword

Stress-induced cardiomyopathy; Takotsubo cardiomyopathy; Nasal packing; Epinephrine

MeSH Terms

Aged*
Anesthesia, Local
Cardiomyopathies*
Coronary Stenosis
Death, Sudden, Cardiac
Epinephrine
Heart Ventricles
Humans
Male*
Myocardial Infarction
Takotsubo Cardiomyopathy
Epinephrine