Open AccessSevere heatstroke complicated with T akotsubo cardiomyopathy
Author(s) -
Tada Yuusuke,
Fukushima Hidetada,
Watanabe Tomoo,
Ito Shingo,
Norimoto Kazunobu,
Ueyama Tooru,
Okuchi Kazuo
Publication year - 2016
Publication title -
acute medicine and surgery
Language(s) - English
Resource type - Journals
ISSN - 2052-8817
DOI - 10.1002/ams2.151
Subject(s) - heatstroke , medicine , coma (optics) , cardiomyopathy , cardiology , glasgow coma scale , pathophysiology , hemodynamics , intensive care unit , acute coronary syndrome , anesthesia , heart failure , myocardial infarction , physics , optics
Case A 69 year‐old female with history of schizophrenia was transported to our hospital by ambulance due to coma. On arrival, she was hypotensive and tachycardic with a G lasgow coma scale score of 3 and a rectal core temperature of 40°C. Heatstroke was strongly suspected as the cause of the coma and hypotension. Active external cooling with an electric fan and cooled IV fluid administration were started. Her electrocardiogram ( EKG ) showed ST elevation in V 2‐6, II , III and a VF . Echocardiography revealed apical ballooning, which indicated T akotsubo cardiomyopathy. Coronary angiography indicated normal coronary arteries. Outcome After admission to the intensive care unit, her cardiovascular status gradually improved and she was transferred to the psychiatric ward on day 36. Conclusion Heatstroke and T akotsubo cardiomyopathy can share the same pathophysiology. Close evaluation of hemodynamic status and myocardial damage is critical for survival.