A Case of Takotsubo Cardiomyopathy Triggered by Human Metapneumovirus

TL;DR

This case report describes the first known instance of Takotsubo cardiomyopathy triggered by human metapneumovirus in an adult.

Contribution

It is the first reported case linking HMPV infection to Takotsubo cardiomyopathy in adults.

Findings

The patient developed acute chest pain and elevated troponin following HMPV infection.

Cardiac catheterization showed normal coronary arteries, and echocardiography confirmed apical ballooning consistent with Takotsubo cardiomyopathy.

This case expands the known complications of HMPV to include Takotsubo cardiomyopathy.

Abstract

Takotsubo cardiomyopathy (TC) is a transient, left ventricular dysfunction and apical ballooning that is commonly associated with emotional or physical triggers; however, it is not a known complication of infection with human metapneumovirus (HMPV). This case report describes a 59-year-old woman with a history of anxiety, depression, seizure disorder, fibromyalgia, and chronic obstructive pulmonary disease, who initially presented to the emergency department with pneumonia and sepsis. A sputum polymerase chain reaction (PCR) was positive for HMPV. The following day after admission, the patient developed acute chest pain, increased troponin that peaked at 12.29 ng/L, and ST-segment elevation in L1, V2-V6 on ECG. Subsequent cardiac catheterization revealed normal coronary arteries, and an echocardiogram showed left ventricular systolic dysfunction with apical ballooning and an ejection fraction of 15%, consistent with a diagnosis of TC. To the best of our knowledge, this is the first reported case of TC in an adult secondary to infection with HMPV and thus marks an important contribution to the current knowledge of HMPV complications.

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