Asthmatic Attack Complicated with Takotsubo Cardiomyopathy after Frequent Inhalation of Inhaled Corticosteroids/Long-Acting Beta2-Adrenoceptor Agonists

Intern Med. 2016;55(12):1615-20. doi: 10.2169/internalmedicine.55.6020. Epub 2016 Jun 15.

Abstract

A 63-year-old man was transferred to our hospital because of an exacerbation of asthma. His symptoms deteriorated even after increasing the dose of inhaled corticosteroids/long-acting beta2-adrenoceptor agonists (ICS/LABA). He had no chest pain and an electrocardiogram revealed ST elevation. A coronary angiogram revealed a reduced left ventricular function with an apical ballooning pattern without coronary stenosis. He was diagnosed with Takotsubo cardiomyopathy. Catecholamine elevation due to acute asthma and an overdose of ICS/LABA may be triggers of this disease. We should remember that Takotsubo cardiomyopathy is a complication of asthma and that catecholamine plays an important role in its onset, although it is essential for asthma treatment.

Publication types

  • Case Reports

MeSH terms

  • Administration, Inhalation
  • Adrenal Cortex Hormones / adverse effects*
  • Adrenal Cortex Hormones / therapeutic use*
  • Adrenergic beta-Agonists / adverse effects*
  • Adrenergic beta-Agonists / therapeutic use
  • Anti-Asthmatic Agents / adverse effects*
  • Anti-Asthmatic Agents / therapeutic use
  • Asthma / drug therapy*
  • Humans
  • Japan
  • Male
  • Middle Aged
  • Takotsubo Cardiomyopathy / drug therapy*
  • Takotsubo Cardiomyopathy / etiology*

Substances

  • Adrenal Cortex Hormones
  • Adrenergic beta-Agonists
  • Anti-Asthmatic Agents