2020 Volume 66 Issue 3 Pages 553-558
An 85-year-old man with non-Hodgkin's lymphoma received a platelet transfusion for thrombocytopenia following chemotherapy. He developed wheezing and dyspnea 20min after the start of the transfusion. A transthoracic echocardiogram revealed severe left ventricular dysfunction (EF 27.3%) and severe apical hypokinesis with disproportionately preserved contraction of the basal segment, suggestive of Takotsubo cardiomyopathy. The patient responded well to a diuretic and the echocardiography findings returned to normal. Takotsubo cardiomyopathy is often associated with a physical or psychological stress that induces sympathetic nerve activity. In our case, allergic reaction to platelet transfusion is likely to be such a stress. Our case also fulfilled the diagnostic criteria of transfusion-associated circulatory overload (TACO), which is a representative adverse reaction to blood transfusion. This suggests that patients diagnosed with TACO may have Takotsubo cardiomyopathy, which may be involved in pathogenesis of TACO. A large study is required to elucidate the pathogenesis of heart failure following blood transfusion.
