Stress-induced Cardiomyopathy Complicating a Stroke Caused by an Air Embolism

Systemic air embolism is a very rare (<0.1%) complication of computed tomography-guided transthoracic needle aspiration and can result in serious neurological and/or cardiac sequelae. Stroke and stress cardiomyopathy can have a variety of etiologies; however, an association of Takotsubo cardiomyopathy with cerebrovascular events precipitated by an air embolus has not been reported. We report a patient with stress-induced cardiomyopathy after an air embolus-induced stroke. The patient was managed with hyperbaric oxygenation and her cardiomyopathy was initially treated as per the acute coronary syndrome protocol until coronary angiography confirmed patent arteries. We review the pathophysiology and management recommendations for both events. Prompt recognition of air embolism-induced cerebrovascular events and stress cardiomyopathy by clinicians is imperative to the timely initiation of appropriate management and a successful treatment outcome.