DOI: 10.36347/sjmcr.2018.v06i03.027

Pages: 214-217

An 82-year-old man intentionally ingested methomyl after arguing with his son. He had a history of alcoholism. Upon arrival, his vital signs were as follows: Glasgow Coma Scale, E1V1M4; blood pressure, 214/94 mmHg; pulse rate, and 116 beats per minute. The physiological findings included fasciculation of the eyelids and moist rales at the right lung. Electrocardiography (ECG) showed sinus tachycardia. He was admitted to the intensive care unit with a diagnosis of organophosphate poisoning and aspiration pneumonia. ECG on the 2nd hospital day showed negative T-waves at the precordial and limb leads with prolongation of the QT correction interval. Echocardiography revealed akinesis of the apical portion of the left ventricle with compensatory hyperkinesis of the basal walls, suggesting Takotsubo-like cardiomyopathy. His cardiac motion and abnormal electrocardiography findings finally improved. Although the pathogenesis of Takotsubo-like cardiomyopathy is not clear at present, the cardiotoxicity induced by methomyl of itself and/or catecholamine-induced microvascular spasms may result in the occurrence of Takotsubo-like cardiomyopathy.