Reversible cardiac dysfunction in long-standing hypertension may be global variant of stress cardiomyopathy

BMJ Case Rep. 2018 Jun 29:2018:bcr2018225044. doi: 10.1136/bcr-2018-225044.

Abstract

An adult man with long-standing poorly controlled cardiac risk factors presented with acute decompensated heart failure (ADHF). Echocardiogram, cardiac MRI and catheterisation suggested idiopathic dilated cardiomyopathy, severe systolic dysfunction, ejection fraction 25% with global left ventricular (LV) dilation and apical thrombus. He responded well to diuretics and gradual uptitration of lisinopril and carvedilol. Follow-up echocardiogram in 2 months demonstrated complete recovery of systolic function, normalisation of LV size and shape with severe LV hypertrophy. This presentation is potentially a global variant of stress cardiomyopathy with recovery of LV function, highlighting the importance of appropriate imaging, catheterisation and clinical monitoring in patients with ADHF.

Keywords: heart failure; hypertension.

Publication types

  • Case Reports

MeSH terms

  • Cardiac Catheterization
  • Cardiotonic Agents / therapeutic use
  • Coronary Angiography
  • Diagnosis, Differential
  • Echocardiography
  • Humans
  • Hypertension / complications*
  • Lisinopril / therapeutic use
  • Magnetic Resonance Imaging
  • Male
  • Middle Aged
  • Takotsubo Cardiomyopathy / complications*
  • Takotsubo Cardiomyopathy / diagnosis*
  • Takotsubo Cardiomyopathy / therapy

Substances

  • Cardiotonic Agents
  • Lisinopril