Stress Cardiomyopathy Precipitated by Withdrawal of Epoprostenol

William J Gionfriddo; Hanna N Ahmed; Harrison W Farber

doi:10.1016/j.jaccas.2019.10.040

Stress Cardiomyopathy Precipitated by Withdrawal of Epoprostenol

JACC Case Rep. 2020 Feb 5;2(2):289-293. doi: 10.1016/j.jaccas.2019.10.040. eCollection 2020 Feb.

Authors

William J Gionfriddo¹, Hanna N Ahmed², Harrison W Farber³

Affiliations

¹ Division of Cardiology, Tufts Medical Center, Boston, Massachusetts.
² Division of Cardiology, University of Massachusetts Memorial Medical Center, Worcester, Massachusetts.
³ Division of Pulmonary, Critical Care, and Sleep Medicine, Tufts Medical Center, Boston, Massachusetts.

Abstract

We describe a case of stress-induced cardiomyopathy following epoprostenol withdrawal. A patient with pulmonary arterial hypertension presented with a malfunctioning Hickman catheter. Inappropriate withdrawal of epoprostenol resulted in shock. Evaluation confirmed stress-induced cardiomyopathy. Restarting epoprostenol resolved the electrocardiographic and echocardiographic abnormalities. This case meets Taskforce on Takotsubo Syndrome Stress-Induced Cardiomyopathy criteria. (Level of Difficulty: Beginner.).

Keywords: ECG, electrocardiogram; LV, left ventricle; RV, right ventricle; acute heart failure; cardiogenic shock; epoprostenol; pulmonary arterial hypertension; stress cardiomyopathy.

Publication types

Case Reports