Asthmatic Attack Complicated with Takotsubo Cardiomyopathy after Frequent Inhalation of Inhaled Corticosteroids/Long-Acting Beta2-Adrenoceptor Agonists

Nayuta Saito; Manabu Suzuki; Satoru Ishii; Eriko Morino; Jin Takasaki; Go Naka; Motoyasu Iikura; Yuichiro Takeda; Masayuki Hojo; Haruhito Sugiyama

doi:10.2169/internalmedicine.55.6020

CASE REPORTS

Asthmatic Attack Complicated with Takotsubo Cardiomyopathy after Frequent Inhalation of Inhaled Corticosteroids/Long-Acting Beta2-Adrenoceptor Agonists

Nayuta Saito, Manabu Suzuki, Satoru Ishii, Eriko Morino, Jin Takasaki, Go Naka, Motoyasu Iikura, Yuichiro Takeda, Masayuki Hojo, Haruhito Sugiyama

Author information

Nayuta Saito
Division of Respiratory Medicine, National Center for Global Health and Medicine, Japan
Division of Respiratory Diseases, Department of Internal Medicine, The Jikei University School of Medicine, Japan
Manabu Suzuki
Division of Respiratory Medicine, National Center for Global Health and Medicine, Japan
Satoru Ishii
Division of Respiratory Medicine, National Center for Global Health and Medicine, Japan
Eriko Morino
Division of Respiratory Medicine, National Center for Global Health and Medicine, Japan
Jin Takasaki
Division of Respiratory Medicine, National Center for Global Health and Medicine, Japan
Go Naka
Division of Respiratory Medicine, National Center for Global Health and Medicine, Japan
Motoyasu Iikura
Division of Respiratory Medicine, National Center for Global Health and Medicine, Japan
Yuichiro Takeda
Division of Respiratory Medicine, National Center for Global Health and Medicine, Japan
Masayuki Hojo
Division of Respiratory Medicine, National Center for Global Health and Medicine, Japan
Haruhito Sugiyama
Division of Respiratory Medicine, National Center for Global Health and Medicine, Japan

Keywords: asthmatic attack, Takotsubo cardiomyopathy, inhaled corticosteroids/long-acting beta2-adrenoceptor agonists, catecholamine

JOURNAL OPEN ACCESS

2016 Volume 55 Issue 12 Pages 1615-1620

DOI https://doi.org/10.2169/internalmedicine.55.6020

Details

Abstract

A 63-year-old man was transferred to our hospital because of an exacerbation of asthma. His symptoms deteriorated even after increasing the dose of inhaled corticosteroids/long-acting beta2-adrenoceptor agonists (ICS/LABA). He had no chest pain and an electrocardiogram revealed ST elevation. A coronary angiogram revealed a reduced left ventricular function with an apical ballooning pattern without coronary stenosis. He was diagnosed with Takotsubo cardiomyopathy. Catecholamine elevation due to acute asthma and an overdose of ICS/LABA may be triggers of this disease. We should remember that Takotsubo cardiomyopathy is a complication of asthma and that catecholamine plays an important role in its onset, although it is essential for asthma treatment.

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