Takotsubo cardiomyopathy, also known as “apical ballooning syndrome”, is generally precipitated by endogenous or exogenous stress, and eating disorders have a variety of physical complications.
We present a case involving a 37-year-old Japanese female with eating disorders. She was admitted because of emaciation with shortness of breath and tiredness, and her weight was 30.0 kg (BMI 10.5 kg/m2) at this admission. On the afternoon of the first hospital day, a simple measurement caused hypoglycemia of 20 mg/dL, and she lost consciousness. On the night of the second hospital day, electrocardiogram showed negative T waves in II, III, aVf, and V1-6. Ultrasound echo showed hypokinesia at the apex of the heart and hypercontraction at the base of the heart. The left ventricular ejection fraction was 20%. Rest and oxygen administration gradually improved her cardiac function; the left ventricular ejection fraction also improved to 50% based on echocardiography. Finally, her weight increased by 43kg (BMI 15.2 kg/m2) with psychiatric treatment, and she was discharged.
The present case shows the clinical features of Takotsubo cardiomyopathy induced by a hypoglycemic event in addition to underlying anorexia nervosa.