Stress-induced (takotsubo) cardiomyopathy following thoracic epidural steroid injection for postherpetic neuralgia.

We present what may be the first documented case of takotsubo cardiomyopathy following a thoracic epidural steroid injection. The 77-year-old patient had many risk factors predisposing her to takotsubo cardiomyopathy, including gender, postmenopausal status, and numerous recent stressful events in her life. Although she presented to the emergency department with symptoms of an acute myocardial infarction, her findings on electrocardiography, echocardiography, coronary angiography, and cardiac enzymes supported the diagnosis of takotsubo cardiomyopathy. While takotsubo cardiomyopathy is rare, it is important for the clinician to distinguish it from an acute myocardial infarction, as the two conditions present similarly but may have distinctly different clinical outcomes.