Takotsubo Cardiomyopathy After Cocaine Intoxication.

Abstract

IntroductionCocaine is a highly addictive substance that stimulates the sympathetic nervous system and cardiovascular system. A multitude of adverse cardiovascular events are associated with cocaine use including arrhythmia, congestive heart failure, coronary artery spasm and myocarditis.Case ReportWe present a rare case of Takotsubo cardiomyopathy after recent use of cocaine in a female without any other identifiable risk factor.DiscussionTakotsubo cardiomyopathy (TCM) is a reversible cause of cardiomyopathy characterized by transient decrease in ejection fraction. Cocaine is a sympathomimetic that causes catecholamine surge and a variety of cardiovascular abnormalities. The association of cocaine use with Takotsubo cardiomyopathy is a rare occurrence, however the prognosis is generally good if diagnosis is made promptly.ConclusionPhysician vigilance is required to diagnose this rare cause of cardiomyopathy and reduce morbidity and mortality.LEARNING POINTSThis case highlights the need to investigate the use of cocaine in patients with cardiovascular disease because it may influence the disease diagnosis and management strategies.Left heart catheterization is imperative for diagnosis, and cessation of cocaine is the primary goal of post discharge therapy.This case shows that TCM should be suspected in a patient with a history of cocaine use.