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CASE REPORT
Year : 2017  |  Volume : 5  |  Issue : 2  |  Page : 41-43

Postpartum inverted takotsubo cardiomyopathy after intravenous atropine administration


1 Professor of Cardiology, Departamento de Medicina Interna y Centro de Investigaciones Biomedicas, Escuela de Medicina, Universidad de Valparaiso, Chile
2 Professor of Cardiology, Department of Cardiovascular Sciences, Hammersmith Hospital, Imperial College London, NHLI, Hammersmith Hospital, London W12 1NN, UK

Correspondence Address:
Rienzi Diaz-Navarro
4 Poniente 332, PO Box 2520192, Vina del Mar
Chile
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Source of Support: None, Conflict of Interest: None


DOI: 10.5812/acvi.46095

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Postpartum Takotsubo cardiomyopathy is mainly induced by drugs that enhance sympathetic nervous activity. We report a novel case of postpartum inverted Takotsubo cardiomyopathy triggered by intravenous atropine administration resulting in acute pulmonary edema. Cardiac troponin I and beta-type natriuretic peptide were elevated. Transthoracic color Doppler echocardiography demonstrated a nondilated left ventricle with mid-basal akinesis, a hyperdynamic apex, and moderate-to-severe mitral regurgitation likely linked to papillary muscle dysfunction. Coronary computed tomography angiography revealed normal coronary arteries. Atropine inhibits the parasympathetic nervous system, alters the autonomic system balance, and, thus, leads to increased sympathetic nervous activity, which seems to have been the cause of Takotsubo cardiomyopathy in this patient. Atropine should be listed among the drugs triggering Takotsubo cardiomyopathy.


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