When a Tooth Pulls the Heart Strings: Takotsubo Cardiomyopathy Post-dental Extraction

Takotsubo cardiomyopathy, also known as stress-induced is a temporary left ventricular dysfunction caused by catecholamine surge under severe stress. It's characterized chest pain, non-specific ECG changes, and apical ballooning observed during catheterization. We present case of 59-year-old postmenopausal female with past medical history asthma who arrived at the ED complaining pain following dental extraction. The patient's abnormal findings elevated cardiac enzymes required catheterization, which revealed normal coronary vasculature but demonstrated ballooning. Transthoracic echocardiogram (TTE) showed septal hypertrophy, decreased ejection fraction (EF), akinetic segments consistent takotsubo cardiomyopathy. Secondary cardiomyopathy induced stress in setting procedures like tooth extraction for periapical abscess rarely described literature. Our serves reminder potential women, especially those undiagnosed underlying anxiety disorders, even minimally invasive procedures.