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Ann Geriatr Med Res > Volume 17(4); 2013 > Article
Journal of the Korean Geriatrics Society 2013;17(4):219-222.
DOI: https://doi.org/10.4235/jkgs.2013.17.4.219    Published online December 31, 2013.
Atypical Stress Induced Cardiomyopathy During Endoscopic Sinus Surgery With Septoplasty in an Elderly Male Patient
Hee Sook Lee, Jae Ryung Yi, Yu Na Jung, Gi Ho Jo, Jung Ju Sir, Seung Min Choi
Department of Internal Medicine, Cardiovascular Center, National Medical Center, Seoul, Korea. inn0centlhs@gmail.com
Stress-induced cardiomyopathy, also known as Takotsubo cardiomyopathy, is caused by emotional or physical stressors and mimics acute myocardial infarction. Stress-induced cardiomyopathy is characterized by acute, reversible left ventricular apical ballooning without significant coronary artery stenosis. New variants of stress-induced cardiomyo pathy with localized wall motion abnormalities or an inverted pattern with a hyperdynamic apex have been reported. We present a rare case of a sudden cardiac arrest due to atypical stress-induced cardiomyopathy (mucosal packing and the injection of epinephrine) in an elderly male patient during elective endoscopic sinus surgery with septoplasty under local anesthesia. In this case, only the basal and midportions of the left ventricle were affected, whereas the apex was completely spared. The patient rapidly and completely recovered without sequelae.
Key Words: Stress-induced cardiomyopathy, Takotsubo cardiomyopathy, Nasal packing, Epinephrine

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