When Too Many Hits Break the Heart: A Case of Radiation Induced Takotsubo Cardiomyopathy

Abstract

Takotsubo cardiomyopathy (TCM), or stress induced cardiomyopathy is being increasingly recognized as a cause of acute heart failure. Often seen in women and older individuals with acute stressors, it can cause significant hemodynamic compromise. Here we report a case of a 78 year old woman who developed sudden chest pain following radiation therapy for B-Cell lymphoma. Echocardiogram revealed newly reduced ejection fraction and cardiac catheterization showed non obstructive coronary disease. Left ventriculogram revealed apical ballooning, characteristic of TCM. Often linked to physical and emotional stressors, TCM has been found to be more prevalent in patients with malignancies.

Keywords: B-cell lymphoma; Left ventricular dysfunction; Radiation; Stress induced cardiomyopathy; Takotsubo cardiomyopathy.