How you treat your patients today, affects them tomorrow: Sinus tachycardia-induced cardiomyopathy

Background: Tachycardia-induced cardiomyopathy (TCM) is a reversible form of myocardial dysfunction because of tachyarrhythmias. Therefore, it is essential to identify arrhythmias in patients presenting with myocardial dysfunction without apparent aetiology.

Case: Herein, we present a thirty-seven-year-old male with bouts of prolonged sinus tachycardia and severe mental stress, averaging >130 beats per minute, before abdominal operations more than once in a few months. A notably dynamic ventricular stunning was noted that partially normalized in a few days, once relieving relieving tension and reduced heart rate. Complete normalization of ventricular function was observed after five months of maintaining the average heart rate. Initially, the present case was missed due to its paroxysmal nature. Later, the patient was cured with a maximum tolerated dose of beta-blockers, anti-failure, and small doses of anxiolytic agents. Our case is a rare case report of recurrent TCM the same patient due to episodes of marked sinus tachycardia.

Conclusion: Sinus tachycardia is often considered a physiological response to mental stress that may cause cardiac injury related to a prolonged stress response. Treatment of stress sinus tachycardia-induced cardiomyopathy (sinus tachycardia-ICM) leads to recovery of myocardial function. The literature does not recommend controlling heart rates in patients with persistent sinus tachycardia preoperatively, but it is a therapeutic option for preparing patients for operation. Successfully, beta-blockers were used in our patient and should be considered in similar case scenarios.