ArticleCureus2022
A Fatal Case of Takotsubo Cardiomyopathy Secondary to Refractory Hypoglycemia in Severe Starvation: An Autopsy Case Report.
Article in Cureus, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.
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Who cites it
6 citing papers in PubMed, 6 citations in OpenAlex.
- Prognostic impact of SGLT2 inhibitors in acute decompensated heart failure patients stratified by admission systolic blood pressure: a retrospective cohort study.BMC cardiovascular disorders · 2026Article
- Summary of the best evidence for perioperative enteral nutrition management in patients with laryngeal cancer.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2025Review
- Mechanical Circulatory Support Strategies in Takotsubo Syndrome with Cardiogenic Shock: A Systematic Review.Journal of clinical medicine · 2024Review
- Article
- Right thyrocervical trunk rupture after right internal jugular vein puncture: a case report and systematic review of the literature.JA clinical reports · 2022Article
- Takotsubo cardiomyopathy associated with pneumatosis cystoides intestinalis and postprandial hypoglycemia of anorexia nervosa.PCN reports : psychiatry and clinical neurosciences · 2022Article
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Authors and funding
5 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
A 56-year-old, severely malnourished man presented with loss of consciousness due to hypoglycemia. Echocardiography revealed left ventricular apical ballooning, indicating takotsubo cardiomyopathy. Although his caloric intake was gradually increased to avoid refeeding syndrome, hypoglycemia was refractory, and repetitive glucose administration was required. On day 4 of admission, he developed severe refractory hypoglycemia with a progressive decrease in blood pressure. Consequently, pulseless ventricular tachycardia followed by pulseless electrical activity developed. Although venoarterial extracorporeal membrane oxygenation was introduced, the patient did not respond to the treatment and died. Autopsy revealed myocardial degeneration and contraction-band necrosis, indicative of takotsubo cardiomyopathy. No coronary stenosis was observed. The liver showed moderate hepatocyte atrophy and autophagosomes, consistent with starvation and not with refeeding syndrome. We speculated that refractory hypoglycemia induced extreme catecholamine secretion, which led to severe complications of takotsubo cardiomyopathy, such as fatal arrhythmia and extremely low cardiac output. Early recognition of these critically ill patients and timely therapeutic interventions, including strict glycemic control and adequate caloric intake, may improve patient outcomes.
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