Takotsubo Cardiomyopathy In Association With Dka In A Blind Pump Patient

ABSTRACT Objective: This is a case report and literature review of an unusual case of diabetic ketoacidosis (DKA) in a blind patient complicated by Takotsubo cardiomyopathy. Methods: Chart review and literature review. Results: A 70-year-old blind woman with long-standing type 1 diabetes using an insulin pump was found to be in DKA. The most likely etiology of the DKA was that the patient filled her pump reservoir with air as there was no evidence of an insulin occlusion or kink in the tubing. An echocardiogram performed 4 days after admission showed a left ventricle of normal size with a large apical aneurysm typical of Takotsubo cardiomyopathy. A repeat echocardiogram taken 18 days after admission showed a left ventricle of normal size with no aneurysm. Conclusion: This is the third adult case and the oldest patient reported with Takotsubo cardiomyopathy following DKA. Takotsubo cardiomyopathy needs to be considered for any patient presenting with heart failure after treatment of DKA. Blind pump patients also have special needs and either need routine assistance for preparing their pump or should consider multiple injections. Abbreviations: DKA = diabetic ketoacidosis; CSII = continuous subcutaneous insulin infusion