Inverted Takotsubo syndrome in Androctonus australis scorpion envenomation

AbstractContext: The nature of scorpion-related cardiomyopathyis still a matter of debate where specific toxin-induced cardiomyopathy, ischemic, or catecholaminergic cardiomyopathyis advocated as well. We report two cases of Takotsubo syndromefollowing envenomationby Androctonus australis, bringing new evidence for the fundamental role of catecholamines in the pathogenesis of this cardiomyopathy.Case 1: A woman aged 36 presented with pulmonary edemaand shock following scorpion envenomation. Echocardiography-Doppler showed a LVEF at 30%. Cardiac magnetic resonance (CMR) imaging showed a basal ballooning of the left and right ventriclessuggestive of an inverted biventricular Takotsubo syndrome. A second CMR performed after recovery was normal.Case 2: A woman aged 45 was admitted for pulmonary edemaand shock consecutive to scorpion envenomation. Echocardiography showed a LVEF at 35%. CMR showed a basal ballooning. The patient was discharged four days following admission with a normal LV function on re...