Case Reports Journal Article Epublish 1 citation
PubMed: 39451870 DOI: 10.3390/clinpract14050155
Acute Heart Failure in a Young Patient Treated in ICU-Diagnostic Pitfalls.
Clin Pract 14(5):1953-1959
Authors: Łukasz Surówka, Paweł Andruszkiewicz, Monika Budnik, Robert Kowalik, Agnieszka Milner, Mateusz Zawadka
Affiliations
- 2nd Department of Anaesthesiology and Intensive Care, Medical University of Warsaw, 02-097 Warsaw, Poland.
- Department of Cardiology, Medical University of Warsaw, 02-097 Warsaw, Poland.
- Department of Medical Microbiology, Medical University of Warsaw, 02-097 Warsaw, Poland.
Abstract
and human herpesvirus 6 (HHV-6) are uncommon aetiological agents in respiratory tract infections and are rarely associated with cardiogenic shock. This case report presents a rare instance of severe cardiomyopathy linked to these infections in a 19-year-old Asian female. The case highlights the importance of considering a broad differential diagnosis in acute heart failure, especially in young adults. The patient was admitted with chest pain and diagnosed with ST-elevation myocardial infarction (STEMI) based on electrocardiography. She subsequently developed heart failure, with a marked reduction in myocardial contractility and a left ventricular ejection fraction (LVEF) of 20%. Treatment included broad-spectrum antibiotics and inotropic support guided by hemodynamic monitoring, leading to clinical improvement. The patient was discharged in a significantly improved condition following a stay in the intensive care unit (ICU). This case emphasizes the importance of considering Takotsubo syndrome in differential diagnoses, especially in ICU patients presenting with cardiogenic shock, to improve outcomes and reduce mortality through timely and appropriate management. Inotropic support, often used in the ICU to treat hypoperfusion, may worsen outcomes in patients with Takotsubo syndrome by exacerbating basal hypercontractility and prolonging the acute phase through catecholamine receptor activation.
MeSH
Diagnosis, Differential, Shock, Cardiogenic, Heart Failure, Heart, Herpesvirus 6, Human, St Elevation Myocardial Infarction, Myocarditis, Diagnosis, Intensive Care Units, Infections, Cardiomyopathies