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Takotsubo cardiomyopathy due to profound hypoglycemia complicated by torsades de pointes and cardiac arrest.

Vitaly Buza, Michael O'Shaughnessy, Julius M Gardin, Mark Klapholz

Takotsubo cardiomyopathy is characterized by temporary left ventricular dysfunction generally in the setting of physical or emotional stress. This case describes a patient originally admitted for altered mental status due to presumed uremic encephalopathy who developed prolonged QT_c leading to torsades de pointes and ventricular fibrillation (V-fib) arrest during her hospital stay, with echocardiographic evidence of Takotsubo cardiomyopathy. It should be recognized by clinicians that stress-induced cardiomyopathy can by precipitated by metabolic derangements such as severe hypoglycemia or heroin withdrawal and complicated by significant arrhythmic events such as torsades de pointes and ventricular fibrillation.