Stress-induced cardiomyopathy as a variant of cardiac injury in mine-blast polytrauma in a young male patient (clinical case report)

Oleg V. Ermilov , Andrey Yu. Tretyakov , Stanislav I. Alyokhin , Petr K. Alferov , Mikhail A. Tretyakov , Stefka G. Radenska-Lopovok , Amina V. Marunich

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Abstract

Stress-induced cardiomyopathy is a relatively rare paratraumatic event with a distinct and quite specific semiology. In practice, this condition is encountered primarily in vascular centers specializing in providing medical care to individuals with symptoms of acute coronary syndrome. A relatively high incidence of this nosology is observed among postmenopausal women. However, this rule is not absolute. This pathology is described significantly less frequently in men and is represented by individual clinical observations. The living conditions of the civilian population in certain regions of the Belgorod region determine an increasing number of casualties as a result of hostilities. In this context, the description of clinical observations of such a pathological condition of the myocardium in young individuals exposed to mine-blast trauma with concomitant traumatic brain injury seems relevant.

Keywords: blunt chest trauma, cardiac trauma, stress-induced cardiomyopathy, mine-blast trauma.

References

1. Paur H, Wright PT, Sikkel MB et al. High levels of circulating epinephrine trigger apical cardiodepression in a β2-adrenergic receptor/Gi-dependent manner: a new model of Takotsubo cardiomyopathy. Circulation 2012;126(6):697-706. DOI: 10.1161/CIRCULATIONAHA.112.111591

2. Алиева А.М., Резник Е.В., Хачирова Э.А. и др. Кардиомиопатия такоцубо у женщины 78 лет (клиническое наблюдение). Русский медицинский журнал. Медицинское обозрение. 2025;9(1):85-92.

Alieva A.M., Reznik E.V., Khachirova E.A. et al. Takotsubo cardiomyopathy in a 78-year-old woman: case report. Russian Medical Journal. Medical Review. 2025;9(1):85-92. DOI: 10.32364/2587-6821-2025-9-1-11.83 (in Russian).

3. Донец Е.К., Намитоков А.М., Кручинова С.В., Космачева Е.Д. Динамическая обструкция выводного тракта левого желудочка как возможное осложнение кардиомиопатии такоцубо. Южно-Российский журнал терапевтической практики. 2021;2(3):94-105. DOI: 10.21886/2712-8156-2021-2-3-94-105

Donets E.K., Namitokov A.M., Kruchinova S.V., Kosmacheva E.D. Dynamic obstruction of the left ventricular outflow tract as a possible complication of takotsubo cardiomyopathy. South Russian Journal of Therapeutic Practice. 2021;2(3):94-105. DOI: 10.21886/2712-8156-2021-2-3-94-105 (in Russian).

4. Небиева Д.Х., Павлов Б.В., Амирасланов Ш.Ш. и др. Уникальный клинический случай: стресс-индуцированная кардиомиопатия. Кардиология в Беларуси. 2024;16(5):552-62. DOI: 10.34883/PI.2024.16.5.011

Nebieva D.Kh., Pavlov B.V., Amiraslanov Sh.Sh. et al. A unique clinical case: stress-induced cardiomyopathy. Cardiology in Belarus. 2024;16(5):552-62. DOI: 10.34883/PI.2024.16.5.011 (in Russian).

5. Girolamo OC, Surikow SY, Ong GJ et al. TakoTsubo Syndrome: first an acute coronary vasculitis and then prolonged myocarditis? Rev Cardiovasc Med 2022;23(5):152. DOI: 10.31083/j.rcm2305152

6. Shimizu M, Nishizaki M, Yamawake N et al. J Wave and Fragmented QRS Formation During the Hyperacute Phase in Takotsubo Cardiomyopathy. Circ J 2014;78(4):943-49. DOI: 10.1253/circj.CJ-13-1296

7. Ghadri JR, Kato K, Cammann VL et al. Long-term prognosis of patients with Takotsubo syndrome. J Am Coll Cardiol 2018;72(8):874-82. DOI: 10.1016/j.jacc.2018.06.016

8. Ayele GM, Atalay R, Slater K et al. Shattered Hearts: Exploring Takotsubo Cardiomyopathy Triggered by a Mechanical Fall in an 88-Year-Old Woman. Cureus 2025;17(4):e82651. DOI: 10.7759/cureus.82651

9. Азизова Д.Д., Алдабергенова А.М., Жумабай К.Т. и др. Кардиомиопатия Такоцубо: клинический случай. Русский медицинский журнал. 2021;(9):36-8.

Azizova D.D., Aldabergenova A.M., Zhumabay K.T. et al. Takotsubo cardiomyopathy: a clinical case. Russian Medical Journal. 2021;(9):36-8 (in Russian).

10. Schneider B, Sechtem U. Influence of age and gender in Takotsubo syndrome. Heart Fail Clin 2016;12(4):521-30. DOI: 10.1016/j.hfc.2016.06.001

11. Абдрахманова А.И., Цибулькин Н.А., Амиров Н.Б. и др. Синдром такоцубо в клинике внутренних болезней. Вестник современной клинической медицины. 2017;10(6):49-60. DOI: 10.20969/VSKM.2017.10(6).49-60

Abdrakhmanova A.I., Tsibulkin N.A., Amirov N.B. et al. Takotsubo syndrome in the clinic of internal diseases. Bulletin of Modern Clinical Medicine. 2017;10(6):49-60. DOI: 10.20969/VSKM.2017.10(6).49-60 (in Russian).

12. Яшин С.С., Киреева А.О., Сухачев П.А. Стресс-индуцированная кардиомиопатия (синдром такоцубо). Инновационная медицина Кубани. 2023;(1):111-5. DOI: 10.35401/2541-9897-2023-26-1-111-115

Yashin S.S., Kireeva A.O., Sukhachev P.A. Stress-induced cardiomyopathy (Takotsubo syndrome). Innovative Medicine of Kuban. 2023;(1):111-5. DOI: 10.35401/2541-9897-2023-26-1-111-115 (in Russian).

13. Eitel I, von Knobelsdorff-Brenkenhoff F, Bernhardt P et al. Clinical characteristics and cardiovascular magnetic resonance findings in stress (takotsubo) cardiomyopathy. JAMA 2011;306(3):277-86. DOI: 10.1001/jama.2011.992

14. Харина Т.П., Таряник П.В., Геращенко Е.В. и др. Синдром «разбитого сердца» или стресс-индуцированная кардиомиопатия (синдром такоцубо). Здоровье. Медицинская экология. Наука. 2026;1(64):55-60.

Kharina T.P., Taryanik P.V., Gerashchenko E.V. et al. The "broken heart" syndrome or stress-induced cardiomyopathy (Takotsubo syndrome). Health. Medical Ecology. Science. 2026;1(64):55-60 (in Russian).

15. Shabbir T, Kal S, Gupta S et al. An Incidental Finding of Takotsubo Cardiomyopathy in a Trauma Case. Cureus. 2023;15(2):e35106. DOI 10.7759/cureus.35106

16. Lyon AR, Bossone E, Schneider B et al. Current state of knowledge on Takotsubo syndrome: a Position Statement from the Taskforce on Takotsubo Syndrome of the Heart Failure Association of the European Society of Cardiology. Eur J Heart Fail 2016;18(1):8-27. DOI: 10.1002/ejhf.424

17. Leech C, Turner J. Shock in trauma. Emergency Medicine Clinics 2023;41(1):1-17. DOI: 10.1016/j.emc.2022.09.007

18. Евдокимова А.Г., Стрюк Р.И., Евдокимов В.В. и др. Синдром такоцубо (стресс-индуцированная кардиомиопатия): клиническое наблюдение. CardioСоматика. 2022;13(2):107-14. DOI: 10.17816/CS110908

Evdokimova A.G., Stryuk R.I., Evdokimov V.V. et al. Takotsubo syndrome (stress-induced cardiomyopathy): a clinical case. CardioSomatics. 2022;13(2):107-14. DOI: 10.17816/CS110908 (in Russian).

19. Salamanca J, Alfonso F. Takotsubo syndrome: unravelling the enigma of the broken heart syndrome? A narrative review. Cardiovasc Diagn Ther 2023;13(6):1080-103. DOI: 10.21037/cdt-23-283

20. Santos JRU, Brofferio A, Viana B, Pacak K. Catecholamine-induced cardiomyopathy in pheochromocytoma: how to manage a rare complication in a rare disease? Horm Metab Res 2019;51(07):458-69. DOI: 10.1055/a-0856-5352

21. Adameova A, Abdellatif Y, Dhalla NS. Role of the excessive amounts of circulating catecholamines and glucocorticoids in stress-induced heart disease. Can J Physiol Pharmacol 2009;87(7):493-514. DOI: 10.1139/y09-042

22. Rona G. Catecholamine Cardiotoxicity. J Mol Cell Cardiol 1985;17(5):291-306. DOI: 10.1016/s0022-2828(85)80130-9

23. Fleckenstein A, Janke J, Doring HJ, Pachinger O. Ca overload as determinant factor in the production of catecholamine induced myocardial lesion. In: Bajusz E, Rona G, Brink AJ, Lochner A, editors. Recent Advances in Studies on Cardiac Structure and Metabolism. Vol 2. Baltimore, MD: University Park Press, 1973; р.455-66.

24. Bloom S, Davis DL. Calcium as mediator of isoproterenol-induced myocardial necrosis. Am J Pathol 1972;69(3):459-70.

25. Heubach JF, Blaschke M, Harding SE et al. Cardiostimulant and cardiodepressant effects through overexpressed human β2-adrenoceptors in murine heart: regional differences and functional role of β1-adrenoceptors. Naunyn Schmiedebergs Arch Pharmacol 2003;367(4):380-90. DOI: 10.1007/s00210-003-0693-8

26. Pathan N, Hemingway CA, Alizadeh AA et al. Role of interleukin 6 in myocardial dysfunction of meningococcal septic shock. Lancet 2004;363(9404):203-9. DOI: 10.1016/S0140-6736(03)15326-3

27. Lyon AR, Rees PS, Prasad S et al. Stress (Takotsubo) cardiomyopathy: a novel pathophysiological hypothesis to explain catecholamine-induced acute myocardial stunning. Nat Clin Pract Cardiovasc Med 2008;5(1):22-9. DOI: 10.1038/ncpcardio1066

28. Prasad A, Lerman A, Rihal CS. Apical ballooning syndrome (Tako-Tsubo or stress cardiomyopathy): a mimic of acute myocardial infarction. Am Heart J 2008;155(3):408-17. DOI: 10.1016/j.ahj.2007.11.008

29. Moderato L, Monello A, Lazzeroni D et al. Takotsubo syndrome during SARS-CoV-2 pneumonia: a possible cardiovascular complication. G Ital Cardiol (Rome) 2020;21(6):417-20. DOI: 10.1714/3366.33414

30. Templin C, Ghadri JR, Diekmann J et al. Clinical features and outcomes of takotsubo (stress) cardiomyopathy. N Engl J Med 2015;373(10):929-38. DOI: 10.1056/NEJMoa1406761

31. Kosuge M, Ebina T, Hibi K et al. Simple and accurate electrocardiographic criteria to differentiate Takotsubo cardiomyopathy from anterior acute myocardial infarction. J Am Coll Cardiol 2010;55(22):2514-6. DOI: 10.1016/j.jacc.2009.12.071

32. Madias JE. Transient attenuation of the amplitude of the QRS complexes in the diagnosis of Takotsubo syndrome. Eur Heart J Acute Cardiovasc Care 2014;3(1):28-36. DOI: 10.1177/2048872613514015

33. Wang J, Tang M, Mao KX et al. Idiopathic ventricular fibrillation with fragmented QRS complex and J wave in resting electrocardiogram. J Geriatr Cardiol 2012;9(2):143-7. DOI: 10.3724/SP.J.1263.2012.00010

34. Ogura R, Hiasa Y, Takahashi T et al. Specific findings of the standard 12-lead ECG in patients with 'Takotsubo' cardiomyopathy: comparison with the findings of acute anterior myocardial infarction. Circ J 2003;67(8):687-90. DOI: 10.1253/circj.67.687

35. Zorzi A, Migliore F, Marra MP et al. Electrocardiographic J waves as a hyperacute sign of Takotsubo syndrome. J Electrocardiol 2012;45(4):353-6. DOI: 10.1016/j.jelectrocard.2012.03.001

36. Morita E, Yasue H, Yoshimura M et al. Increased plasma levels of brain natriuretic peptide in patients with acute myocardial infarction. Circulation 1993;88(1):82-91. DOI: 10.1161/01.cir.88.1.82

37. Citro R, Rigo F, D'Andrea A et al. Echocardiographic correlates of acute heart failure, cardiogenic shock, and in-hospital mortality in Tako-Tsubo cardiomyopathy. JACC Cardiovasc Imaging 2014;7(2):119-29. DOI: 10.1016/j.jcmg.2013.09.020

38. Ishida T, Yasu T, Arao K et al. Bedside diagnosis of cardiac rupture by contrast echocardiography. Circulation 2005;112(23):e354-e355. DOI: 10.1161/CIRCULATIONAHA.105.552794

39. Haghi D, Papavassiliu T, Heggemann F et al. Incidence and clinical significance of left ventricular thrombus in Tako-Tsubo cardiomyopathy assessed with echocardiography. QJM 2008;101(5):381-6. DOI: 10.1093/qjmed/hcn030

For citation:Ermilov O.V., Tretyakov A.Yu., Alyokhin S.I., Alferov P.K., Tretyakov M.A., Radenska-Lopovok S.G., Marunich A.V. Stress-induced cardiomyopathy as a variant of cardiac injury in mine-blast polytrauma in a young male patient (clinical case report). Clinical review for general practice. 2026; 7 (6): 143–148 (In Russ.). DOI: 10.47407/kr2026.7.6.00863

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Clinical review for general practice