‘Tax-otsubo’: stress cardiomyopathy following an encounter with the Inland Revenue

Abstract

An 89-year-old man developed chest pain and palpitations shortly after finishing a stressful 40 min phone call to HM Revenue and Customs. After admission to the emergency department, he had a cardiovascular collapse followed soon after by a cardiac arrest due to ventricular fibrillation (VF). The troponin T was elevated and his ECG showed extensive deep T wave inversion with prolongation of the QT interval. A portable hand-held ultrasound device (VScan; GE Healthcare) was used to demonstrate classical apical ballooning of the left ventricular apex indicating a diagnosis of takotsubo stress cardiomyopathy. Shortly following admission to the cardiac care unit, he had a further episode of VF, which was successfully defibrillated. A coronary angiogram was performed, which was normal. He was treated with a short course of benzodiazepines. He was discharged after 8 days without any neurological deficit. His echocardiogram subsequently showed complete resolution of the abnormalities of the left ventricular function.

MFGE8, ALB, APOB, APOE, SAA1, A2M, and C3 as Novel Biomarkers for Stress Cardiomyopathy

“…The reversibility of cardiac insufficiency is one of the most prominent features of the disease. It is sometimes considered fairly benign, but it has a 4.1% in-hospital mortality rate, especially in the early stages analogous to acute coronary syndrome (ACS), and is also likely to have cardiogenic shock and fatal arrhythmias [3]. It estimates that 1 to 2% of suspected ACS patients were eventually diagnosed with stress cardiomyopathy.…”