Postpartum Inverted Takotsubo Cardiomyopathy After Intravenous Atropine Administration

Abstract

Postpartum Takotsubo cardiomyopathy is mainly induced by drugs that enhance sympathetic nervous activity. We report a novel case of postpartum inverted Takotsubo cardiomyopathy triggered by intravenous atropine administration resulting in acute pul-monaryedema. CardiactroponinIandbeta-typenatriureticpeptidewereelevated. TransthoraciccolorDopplerechocardiography demonstrated a nondilated left ventricle with mid-basal akinesis, a hyperdynamic apex, and moderate-to-severe mitral regurgitation likely linked to papillary muscle dysfunction. Coronary computed tomography angiography revealed normal coronary ar-teries. Atropine inhibits the parasympathetic nervous system, alters the autonomic system balance, and, thus, leads to increased sympatheticnervousactivity,whichseemstohavebeenthecauseof Takotsubocardiomyopathyinthispatient. Atropineshouldbe listed among the drugs triggering Takotsubo cardiomyopathy. Cardiomyopathy, Cardiomyopathies, Echocardiography Doppler Color, Atropine