Korean J Fam Pract.  2023 Sep;13(3):187-190. 10.21215/kjfp.2023.13.3.187.

A Case Report of Heat Stroke Induced Inverted Stress Cardiomyopathy

• Jeong JH
• Park YH
• Kim YS

• KMID: 2546234
• DOI: http://doi.org/10.21215/kjfp.2023.13.3.187

Abstract

Heat stroke is a life-threatening illness characterized by an elevated core temperature of >40℃ and dysfunction of the central nervous system, resulting in delirium, convulsions, or coma. Stress cardiomyopathy is characterized by transient regional systolic dysfunction of the left ventricle mimicking myocardial infarction in the absence of angiographic evidence of obstructive coronary artery disease or acute plaque rupture. A 63-year-old man with a history of hypertension visited the emergency room because of convulsions and fever. On arrival, he was in a stupor with a rectal temperature of 40.6℃. A rapid infusion of 1.5 liters of cold isotonic sodium chloride solution was initiated, as was surface cooling with an ice pack. An electrocardiogram revealed ST-segment depression in leads V4–6. Echocardiography revealed a reduced left ventricular ejection fraction (LVEF) of 30% and basal wall hypokinesia. Coronary angiography revealed no obstruction in both coronary arteries. Fourteen days later, follow-up echocardiography showed complete recovery of the LV wall motion with an EF of 64%. We report a rare case of inverted stress cardiomyopathy due to heat stroke.

Keyword

Stress Cardiomyopathy; Takotsubo Cardiomyopathy; Echocardiography; Heat Stroke