Abstract
Takotsubo cardiomyopathy is characterized by the acute onset of a reversible left
ventricular wall motion abnormality that extends beyond a single coronary artery’s
distribution, following a period of emotional or physical stress. We present a 4 yr
11 mo old boy who was admitted to the pediatric intensive care unit a few days following
tonsillectomy and adenoidectomy. The patient presented with mild cyanosis, shortness
of breath and decreased levels of consciousness. Initial investigations revealed significant
hypokinesia and dilatation of the mid and apical segments of the left ventricle along
with preserved function of the basal segment. The patient was given inotropes and
diuretics for hemodynamic management. The patient made a complete recovery with normalization
of cardiac function within 3-4 wk. Upon follow up, the patient had normal sinus rhythm,
improved ejection fraction and no ventricular wall motion abnormalities. The authors
believe the myocarditis, rhabdomyolysis, and sepsis following tonsillectomy and adenoidectomy
to be the stressors in this case. The rarity of cases that phenotypically mimic classical
Takotsubo cardiomyopathy in children makes this case of special interest to pediatricians
and cardiologists.
Keywords
Takotsubo cardiomyopathy - broken heart syndrome - transient left apical ballooning
- stress cardiomyopathy - myocardial stunning
