AlShehabi Nagam, Hallak Yusuf, Battistin Umberto, Faraji Hanan, Othman Malek, Alkowatli Hamza, Butt Mehmood
College of Medicine, Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai, ARE.
Department of Internal Medicine, HCA Florida Blake Hospital, Bradenton, USA.
Cureus. 2024 Jul 20;16(7):e65009. doi: 10.7759/cureus.65009. eCollection 2024 Jul.
Takotsubo cardiomyopathy (TCM) is a transient wall motion abnormality of the left ventricular apex associated with emotional or physical stress. In the setting of diabetic ketoacidosis (DKA), it is thought to be caused by the compound effect of a catecholamine surge and the noxious effect of acidosis and ketones leading to myocardial stunning. In this report, the first of its kind in the Middle East, we describe the case of a 71-year-old comatose patient, who was being treated for DKA and hypernatremia and was incidentally diagnosed with TCM. We also review 15 case reports of DKA-induced TCM published to date in the literature, many of which had an atypical presentation and good outcomes. Furthermore, we discuss possible risk factors for TCM in our case and supporting literature. It is recommended to maintain increased vigilance and attempt early identification of such conditions in acutely ill patients to prevent life-threatening complications.
应激性心肌病（TCM）是一种与情绪或身体应激相关的左心室心尖部短暂性室壁运动异常。在糖尿病酮症酸中毒（DKA）的情况下，认为它是由儿茶酚胺激增以及酸中毒和酮体的有害作用导致心肌顿抑的复合效应引起的。在本报告中，这是中东地区首例此类报告，我们描述了一名71岁昏迷患者的病例，该患者正在接受DKA和高钠血症治疗，偶然被诊断为应激性心肌病。我们还回顾了迄今为止文献中发表的15例DKA诱发应激性心肌病的病例报告，其中许多病例表现不典型但预后良好。此外，我们讨论了我们病例中应激性心肌病可能的危险因素及相关文献。建议在急性病患者中保持更高的警惕性，并尝试早期识别此类情况，以预防危及生命的并发症。
