Abstract
BackgroundAcute pancreatitis as a trigger of Takotsubo cardiomyopathy has been infrequently described in the literature. Misdiagnosis of this phenomenon can often occur due to overlap in symptomology, particularly in those outside of the usual patient demographic.Case presentationA 27-year-old man with a history of alcohol abuse presented with epigastric and chest pain. Electrocardiography showed ischemic changes, and laboratory workup revealed elevated lipase and troponin. He was diagnosed with acute pancreatitis and managed presumptively as acute coronary syndrome. Subsequent coronary angiography was negative for obstructive coronary artery disease, and left ventriculography demonstrated basal hyperkinesis and apical akinesis, characteristic of Takotsubo cardiomyopathy.ConclusionsTakotsubo cardiomyopathy is a rare complication of acute pancreatitis. Increased awareness of this phenomenon is required to prevent delays in diagnosis and avoid unnecessary interventions and complications.
Highlights
Acute pancreatitis as a trigger of Takotsubo cardiomyopathy has been infrequently described in the literature
Takotsubo cardiomyopathy is a rare complication of acute pancreatitis
Whilst there are many well-documented triggers of Takotsubo cardiomyopathy (TCM), the role of acute pancreatitis has been only sporadically mentioned in the literature
Summary
Takotsubo cardiomyopathy (TCM) has increasingly gained international awareness since it was first introduced in 1990 [1]. Whilst there are many well-documented triggers of TCM, the role of acute pancreatitis has been only sporadically mentioned in the literature Increasing awareness of this phenomenon in those outside of the usual patient demographic may lead to earlier diagnosis and avoid unnecessary interventions. We present a rare case of TCM complicating acute alcoholic pancreatitis. In the subsequent hours he developed chest pain On presentation he was tachycardic to 110 beats per minute, febrile to 38.4 °C, and had epigastric tenderness. Kidney function was maintained with a creatinine of 76 μmol/L, and his lipid profile showed only raised triglycerides at 2.5 mmol/L His serial troponins rose from 0.77 ng/mL to 1019.63 ng/mL, and electrocardiography (ECG) revealed ST elevation in the anterior leads (Fig. 1). Follow-up with repeat echocardiography was planned at three months, but the patient did not attend
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