Logo American Journal of Case Reports

Call: 1.631.629.4328
Mon-Fri 10 am - 2 pm EST

Contact Us

Logo American Journal of Case Reports Logo American Journal of Case Reports Logo American Journal of Case Reports

26 October 2019 : Case report  Canada

Diffuse Deep T-Wave Inversions Following a Generalized Seizure

Mistake in diagnosis

Graeme Prosperi-Porta1ABEF*, Christopher Oleynick1ABEF

DOI: 10.12659/AJCR.918566

Am J Case Rep 2019; 20:1572-1575


BACKGROUND: Stress cardiomyopathy (SCM) is a transient dysfunction of the left ventricle due to physical or emotional triggers that produces a range of electrocardiogram (ECG) changes. While ST-segment elevation or depression often leads to more urgent investigation and diagnosis, T-wave inversions can result in delayed diagnosis.

CASE REPORT: A 44-year-old woman with a prior left middle cerebral artery septic embolic stroke from endocarditis resulting in residual dense right sided hemiparesis and aphasia was admitted to the hospital for treatment of Staphylococcus aureus bacteremia. While hospitalized, she experienced a generalized seizure that was aborted with lorazepam and then loaded with phenytoin. Her ECG following the seizure showed a prolonged QT interval, for which her methadone that she was stabilized on during hospitalization was held. Her ECG to follow-up on her QT interval 25 h following the seizure showed new diffuse symmetric deep T-wave inversions. While initially believed to be due to the either the discontinuation of methadone or initiation of phenytoin, retrospective analysis revealed that these changes were more suggestive of a missed SCM.

CONCLUSIONS: We report a patient who experienced a generalized seizure resulting in diffuse, symmetric, deep T-wave inversions that were incorrectly attributed to medication effects before identifying the likely diagnosis of SCM. Fortunately for this patient, there were no consequences of the delayed diagnosis, but this case emphasises the importance of considering SCM following a generalized seizure in any patient with ECG abnormalities.

Keywords: Electrocardiography, Seizures, takotsubo cardiomyopathy, delayed diagnosis, Diagnosis, Differential, Methadone, phenytoin



30 November 2022 : Case report  Gabon

Severe COVID-19 in 2 Kidney Transplant Patients in Gabon

Am J Case Rep In Press; DOI: 10.12659/AJCR.938003  

23 November 2022 : Case report  Grenada

Mepolizumab as a Potential Protective Factor of COVID-19 Mortality: A Case Report of Chronic Bronchitis and...

Am J Case Rep In Press; DOI: 10.12659/AJCR.938450  

In Press

02 Dec 2022 : Case report  Portugal

A 54-Year-Old Woman with Papillary Thyroid Carcinoma Associated with Secondary Amyloid Goiter and Thyroid L...

Am J Case Rep In Press; DOI: 10.12659/AJCR.938156  

02 Dec 2022 : Case report  Saudi Arabia

A 14-Year-Old Saudi Boy with Gynecomastia, Cushing Syndrome, Large-Cell Calcifying Sertoli Cell Tumor of th...

Am J Case Rep In Press; DOI: 10.12659/AJCR.937404  

01 Dec 2022 : Case report  China (mainland)

Ureterolithiasis in Human Immunodeficiency Virus (HIV) Patients Treated with Single-Use Ureteroscope: A Cas...

Am J Case Rep In Press; DOI: 10.12659/AJCR.938608  

01 Dec 2022 : Case report  Saudi Arabia

Ancient Schwannoma: Case Report of an Unusual Entity in an Unusual Oral Location

Am J Case Rep In Press; DOI: 10.12659/AJCR.938335  

Most Viewed Current Articles

13 Jul 2022 : Case report  USA

Whistling Scrotum: An Unusual Presentation of Pneumomediastinum in the Setting of an Open Scrotal Wound

DOI :10.12659/AJCR.936441

Am J Case Rep 2022; 23:e936441

23 Feb 2022 : Case report  USA

Penile Necrosis Associated with Local Intravenous Injection of Cocaine

DOI :10.12659/AJCR.935250

Am J Case Rep 2022; 23:e935250

06 Dec 2021 : Case report  Brazil

Lipedema Can Be Treated Non-Surgically: A Report of 5 Cases

DOI :10.12659/AJCR.934406

Am J Case Rep 2021; 22:e934406

17 Feb 2022 : Case report  Oman

Myocarditis, Pulmonary Hemorrhage, and Extensive Myositis with Rhabdomyolysis 12 Days After First Dose of P...

DOI :10.12659/AJCR.934399

Am J Case Rep 2022; 23:e934399

Your Privacy

We use cookies to ensure the functionality of our website, to personalize content and advertising, to provide social media features, and to analyze our traffic. If you allow us to do so, we also inform our social media, advertising and analysis partners about your use of our website, You can decise for yourself which categories you you want to deny or allow. Please note that based on your settings not all functionalities of the site are available. View our privacy policy.

American Journal of Case Reports eISSN: 1941-5923
American Journal of Case Reports eISSN: 1941-5923