Severe reversible myocardial depression in a patient with Pseudomonas aeruginosa sepsis suggesting tako-tsubo cardiomyopathy

Abstract 

Acute coronary syndromes are not uncommon in medical intensive care units. Multiple molecular, pharmacologic, and hemodynamic mechanisms may contribute to the pathogenesis resulting in increased mortality in this setting. Tako-tsubo cardiomyopathy is a recently defined uncommon cardiac syndrome with characteristic features often encountered in patients with hyperadrenergic situations such as emotional stress. Although myocardial depression in sepsis can be expected in previously healthy individuals; tako-tsubo cardiomyopathy is rarely reported in septic patients. In this case report we present a 52 year-old man with sepsis secondary to Pseudomonas pneumonia who developed significant segmental wall motion abnormalities during the disease course. The patient's myocardial function recovered completely soon after the sepsis resolved. Clinical, echocardiographic, and coronary angiographic findings suggested the diagnosis of tako-tsubo cardiomyopathy in this patient.

Keywords: Tako-tsubo cardiomyopathy, Cytokine, Ischemia, Pseudomonas infection