Transient Left Ventricular Contractile Dysfunction during the Treatment of Rhabdomyolysis: A Case Report and Literature Review

Abstract

Transient left ventricular contractile dysfunction (TLVCD) is often observed as a result of stress-related cardiomyopathy; however, recent reports suggest that rhabdomyolysis and eating disorders can also induce the development of TLVCD. We report a 52-year-old malnourished man who developed acute heart failure on day 4 of treatment for rhabdomyolysis. Transthoracic echocardiogram revealed severe hypokinesis at the apical and mid-ventricular segments, except for the basal segments of the left ventricular wall, which recovered within one week. We discuss the pathogenesis of TLVCD with sympathetic nerve activation in association with rhabdomyolysis or refeeding syndrome.

Keywords: cardiomyopathy; echocardiography; refeeding syndrome.

Figure 1.

Chest X-ray on the day of admission (A) and days 4 (B) and 8 (C) after admission.

Figure 2.

Surface electrocardiogram on the day of admission (A) and days 4 (B) and 12 (C) after admission. The corrected QT interval was calculated using Bazett’s formula.

Figure 3.

Laboratory data and treatment after admission.

Figure 4.

Apical four-chamber views of transthoracic echocardiography on day 4 (A and B) and day 12 (C and D) after admission. A and C, end-diastole; B and D, end-systole.