Pyrethroid insecticide-induced takotsubo syndrome

Pyrethroid insecticides are a synthetic formulation of naturally occurring pyrethrins, which are extracted from the flowers of chrysanthemum cinerariaefolium. Pyrethroids make up the majority of common insecticides used against household pests such as mosquitoes, house flies, bed bugs, and cockroaches (1). Takotsubo syndrome is described as a reversible left ventricular (LV) variable wall motion abnormality that occurs in the absence of coronary artery stenosis or acute plaque rupture on angiography (2). Emotional trauma and some medical conditions, such as acute respiratory failure, pancreatitis, cholecystitis, pneumothorax, thyrotoxicosis, pregnancy, carbon-monoxide poisoning, exposure to sympathomimetic drugs, stroke, and intracerebral hemorrhage, have been implicated as triggers of takotsubo syndrome (2). Postmenopausal women are commonly affected by this syndrome. In this article, we report a case of a 96-year-old woman who developed takotsubo syndrome after an accidental exposure to a large amount of pyrethroid insecticide (deltamethrin) via inhalation in a closed space.