Takotsubo Cardiomyopathy and Cardiogenic Shock in a 16-Year-Old With Vaping-Induced Pneumonitis

BACKGROUND: Takotsubo cardiomyopathy (TC) is an uncommon diagnosis, particularly in the pediatric population. The midventricular subtype and presentation with cardiogenic shock are even more unique; the recognition of TC is critical for appropriate management. CASE SUMMARY: We present the case of a 16-year-old young woman who presented with cardiogenic shock. Cardiac magnetic resonance (CMR) confirmed left ventricular dilation, reduced systolic function, and myocardial edema, which are highly consistent with a diagnosis of TC, likely as a consequence of e-cigarette or vaping product use-associated lung injury. The patient was managed with high-dose corticosteroids, beta-blocker, and angiotensin-converting enzyme inhibitor therapy, with recovery of left ventricular function. DISCUSSION: This case emphasizes the importance of recognition of TC in pediatric patients as a cause of cardiogenic shock. The use of CMR is crucial to differentiate causes of undifferentiated cardiogenic shock. TAKE-HOME MESSAGES: Our case highlights the role of CMR as a valuable tool in the diagnosis of acute myocardial dysfunction and potential causes of TC in the adolescent population.