Takotsubo Cardiomyopathy Following Complete Avalanche Burial: A Case Report.

Libersa, Marie, Louis Marxer, Ken Zafren, Stephane Oggier, Lorenzo Pucci, and Mathieu Pasquier. Takotsubo cardiomyopathy following complete avalanche burial: a case report. 22:000-000, 2023.-Takotsubo cardiomyopathy is a transient left ventricular dyskinesia triggered by a stressful physical or emotional event. We report a case of mid-ventricular Takotsubo stress cardiomyopathy in an avalanche victim. The patient was a 41-year-old woman who was completely buried under 1.2 m of snow for 30 minutes. On arrival at the hospital, she was conscious and hypothermic (core temperature 33.7°C). Her ECG showed rapid atrial fibrillation (142 beats/min) that converted to sinus rhythm after rewarming and administration of crystalloids. Echocardiography showed akinesia of the left mid-ventricle with a left ventricular ejection fraction of 41%. At 48-hour follow-up, echocardiography showed an almost complete recovery. During her hospital stay the patient was diagnosed with an acute stress disorder with symptoms of dissociation. She was discharged home after 5 days. At 2-week follow-up echocardiography was normal. Psychological follow-up was normal at 7 months. The physical and psychological stress of the avalanche, as well as hypothermia, were all possible triggers of Takotsubo cardiomyopathy.