Multiple Bee Sting-Induced Life-Threatening Takotsubo Cardiomyopathy.

Abstract

CT value, making it difficult to distinguish between the two. Anemic blood, however, has a low CT value and appears darker, as shown in the descending aorta (Figure F, white arrowheads); therefore, the LV chamber could be easily distinguished even on plane CT. During cardiac arrest, the heart usually stops at the systolic phase, leaving the LV chamber in a collapsed position. This makes it difficult to detect the chamber on plane CT in patients without cardiac asynergy. In this case, however, owing to the low CT signal, remnant blood was detected in the cardiac apex resulting from TCM (Figure F). Moreover, the low-CT-value area in the LV chamber induced by anemic blood extended into the lateral myocardial layer (Figure F), which was the suspected rupture site. TCM following bee stings is very rare, but should be considered in patients with chest pain associated with ECG changes following hymenoptera sting. This is the first imaging and report of post-mortem CT in a patient with ruptured TCM. As in the present case, anemia-induced low CT value of blood could indicate akinesis at the cardiac apex and a suspected rupture site.