J Pediatr Intensive Care 2013; 02(04): 187-192
DOI: 10.3233/PIC-13067
Case Report
Georg Thieme Verlag KG Stuttgart – New York

Takotsubo cardiomyopathy-like phenotype in a boy

Mohammed Firdouse
a   Faculty of Health Sciences, McMaster Children’s Hospital, McMaster University, Hamilton, ON, Canada
,
Arnav Garwal
a   Faculty of Health Sciences, McMaster Children’s Hospital, McMaster University, Hamilton, ON, Canada
,
Claudia Lace De Almeida
b   Department of Pediatrics, McMaster Children’s Hospital, McMaster University, Hamilton, ON, Canada
,
Tapas Mondal
b   Department of Pediatrics, McMaster Children’s Hospital, McMaster University, Hamilton, ON, Canada
› Author Affiliations

Subject Editor:
Further Information

Publication History

27 August 2013

06 November 2013

Publication Date:
28 July 2015 (online)

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.