A Case of Takotsubo Cardiomyopathy Triggered by Human Metapneumovirus

Takotsubo cardiomyopathy (TC) is a transient, left ventricular dysfunction and apical ballooning that is commonly associated with emotional or physical triggers; however, it is not a known complication of infection with human metapneumovirus (HMPV). This case report describes a 59-year-old woman with a history of anxiety, depression, seizure disorder, fibromyalgia, and chronic obstructive pulmonary disease, who initially presented to the emergency department with pneumonia and sepsis. A sputum polymerase chain reaction (PCR) was positive for HMPV. The following day after admission, the patient developed acute chest pain, increased troponin that peaked at 12.29 ng/L, and ST-segment elevation in L1, V2-V6 on ECG. Subsequent cardiac catheterization revealed normal coronary arteries, and an echocardiogram showed left ventricular systolic dysfunction with apical ballooning and an ejection fraction of 15%, consistent with a diagnosis of TC. To the best of our knowledge, this is the first reported case of TC in an adult secondary to infection with HMPV and thus marks an important contribution to the current knowledge of HMPV complications.