126 Increased Rates of Takotsubo Cardiomyopathy During the 2019 New South Wales Bushfires

Abstract

The recent 2019 bushfire was considered one of worse in Australian history. It placed considerable physical and emotional stress on communities throughout New South Wales. During this period, we noted an increased number of patients diagnosed with takotsubo cardiomyopathy at our centre compared with previous years. We performed a retrospective analysis of all patients admitted to Campbelltown Hospital during the bushfire season (between September 1 and December 31) of 2017, 2018 and 2019, respectively. Takotusbo cardiomyopathy was diagnosed based on apical ballooning on left ventriculogram or transthoracic echocardiogram after obstructive coronary artery disease was ruled out by coronary angiography. Diagnoses were correlated with air quality data as per average PM2.5 readings. 11 cases of takotsubo cardiomyopathy were diagnosed at our centre during the 2019 bushfire period compared with 5 cases in 2018 and 4 cases in 2017. All 11 patients were female, with mean age 67.8±11.8 years. 3/11 (27.3%) had diabetes. 7/11 (63.6%) presented with chest pain. Mean left ventricular ejection fraction was 40.1±10.9% and peak high-sensitivity troponin-T was 394.3±260.5 ng/L. 9/11 (82%) patients were diagnosed once the average PM2.5 levels exceeded the ‘moderately unhealthy’ range of 12.1 μg/m3, in comparison to previous years in which the PM2.5 was always less than 10.0 μg/m3. We observed increased rates of takotsubo cardiomyopathy at our centre during the 2019 New South Wales bushfires, which was associated with worsening air quality levels.