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7 results

  • Takotsubo cardiomyopathy in a child with single-ventricle disease

  • Koichi Takamizawa, Shin Ono, Naka Saito, Hideaki Ueda
  • Journal:
    Cardiology in the Young / Volume 33 / Issue 1 / January 2023
    Published online by Cambridge University Press:
    28 April 2022, pp. 141-143
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  • Takotsubo cardiomyopathy, a disease that causes transient contractile abnormalities mainly in the left ventricular apex, is rarely reported in children, especially in those with single-ventricle disease. A 4-year-old boy with a single right ventricle was transferred to our hospital following a severe seizure and was diagnosed with takotsubo cardiomyopathy by echocardiography. His cardiac function improved; however, he developed hypoxic-ischemic encephalopathy.

  • Takotsubo cardiomyopathy in children

  • Prithvi Sendi, Paul Martinez, Madhuradhar Chegondi, Balagangadhar R. Totapally
  • Journal:
    Cardiology in the Young / Volume 30 / Issue 11 / November 2020
    Published online by Cambridge University Press:
    26 August 2020, pp. 1711-1715
  • Objective:

    To explore the epidemiology and outcomes of takotsubo cardiomyopathy in children.

    Methods:

    A retrospective analysis of the Healthcare Cost and Utilization 2012 and 2016 Kids’ Inpatient Database was performed. Patients admitted with the diagnosis of takotsubo cardiomyopathy in the age group of 1 month–20 years were identified using International Classification of Diseases (ICD)-9 code 429.83 and ICD-10 code I51.81.

    Results:

    Among a total of 4,860,859 discharges, there were 153 with the diagnosis of takotsubo cardiomyopathy (3.1 per 100,000 discharges). Among patients with takotsubo cardiomyopathy, 55.0% were male, 62.4% were white, and 16.7% were black. Eighty-nine percent of patients were between 12 and 20 years. Psychiatric diagnosis was documented in 46% and substance use disorder in 36.2%. Sepsis was documented in 22.8% of patients. The median length of stay was 5 days (interquartile range: 2.7–15), and median total charges were $75,080 (interquartile range: 32,176–198,336). The overall mortality for takotsubo cardiomyopathy was 7%. On multivariable regression analysis, mortality was higher in the presence of anoxic injury (odds ratio = 34.42, 95% confidence interval: 4.85–320.11, p = 0.00).

    Conclusions:

    Takotsubo cardiomyopathy is uncommon in children and carries a mortality rate of 7%. Most children with takotsubo cardiomyopathy are adolescent males, many of whom have psychiatric disorder or substance use disorder or both. Takotsubo cardiomyopathy should be considered in the differential diagnosis for patients who present with cardiac dysfunction and have underlying psychiatric disorders or drug abuse.

  • Takotsubo cardiomyopathy secondary to non-accidental trauma presenting as an “unwitnessed” arrest

  • Ryan M. Serrano, Marcus Schamberger, John J. Parent
  • Journal:
    Cardiology in the Young / Volume 29 / Issue 3 / March 2019
    Published online by Cambridge University Press:
    04 February 2019, pp. 442-444

  • Takotsubo cardiomyopathy is characterised by akinesis and ballooning of the left ventricular apex during contraction of the otherwise normal base of the heart. We describe the case of a 7-month-old previously healthy female who presented with an unwitnessed cardiac arrest. Workup raised suspicion for non-accidental trauma. Despite progression to brain death, the severely decreased ventricular function and apical akinesis of the left ventricle improved within 40 hours of admission. This report will familiarise paediatricians with this rare cardiomyopathy and emphasise the importance of considering non-accidental trauma as an inciting event for patients with unwitnessed cardiac arrest found to have decreased ventricular function.

  • Management of airway obstruction with nebulised adrenaline resulting in takotsubo cardiomyopathy: case report

  • F Keshtkar, O T Dale, W O Bennett, C E Hall
  • Journal:
    The Journal of Laryngology & Otology / Volume 130 / Issue 9 / September 2016
    Published online by Cambridge University Press:
    05 July 2016, pp. 883-886
    Print publication:
    September 2016
  • Background:

    Takotsubo cardiomyopathy has been associated with the use of catecholamines; however, its development after the use of nebulised adrenaline for the management of acute airway obstruction has not previously been described.

    Case report:

    A 66-year-old man with squamous cell carcinoma of the larynx, with tumour–node–metastasis staging of T3N2cM0, confirmed by biopsy and computed tomography, presented to the emergency department with acute airway obstruction. He was treated twice with nebulised adrenaline and intravenous dexamethasone. After a period of 24 hours, cardiac rhythm changes were noted on telemetry. A 12-lead electrocardiogram showed widespread T-wave inversion and QT prolongation suggestive of an acute coronary syndrome. Coronary angiography demonstrated no coronary artery disease, but left ventricular angiography showed marked apical ballooning and apical wall akinesia consistent with a diagnosis of takotsubo cardiomyopathy.

    Conclusion:

    Takotsubo cardiomyopathy can mimic true ischaemic heart disease and the diagnosis requires a high index of suspicion in patients managed with nebulised adrenaline.

  • Chapter 19 - Acute care ofeating disorders

  • from Section 3. - Psychiatric illnesses
  • Edited by Leslie S. Zun
  • Edited in association with Lara G. Chepenik, Mary Nan S. Mallory
  • Book:
    Behavioral Emergencies for the Emergency Physician
    Published online:
    05 April 2013
    Print publication:
    21 March 2013, pp 140-149

  • Summary

    This chapter highlights the two specific psychiatric manifestations of trauma, acute stress disorder (ASD) and its counterpart post-traumatic stress disorder (PTSD). It discusses management strategies for patients with ASD/PTSD in the emergency department (ED) and shows how the emergency physician (EP) can effectively identify the various presentations of PTSD, even when the symptoms are sub-threshold for a formal diagnosis. Symptoms of avoidance and re-experiencing are unique to PTSD and should help distinguish it from related anxiety disorders. The potential for clinically relevant physiologic manifestations of psychiatric stress is demonstrated by Takotsubo cardiomyopathy (TCM). In instances when the patient meets the diagnostic criteria for ASD/ PTSD, referral to outpatient psychiatric treatment is recommended. Such therapy may include psychopharmacology and cognitive behavioral, cognitive processing, or exposure therapy. In most practice settings, pharmacologic treatment should be initiated and managed outside of the ED by a primary care physician or mental health professional.