Context: Takotsubo cardiomyopathy (TC) is a transient stress-induced cardiomyopathy with left ventricular dysfunction of unknown etiology. A well accepted theory for the pathophysiology of TC is attributed to a massive catecholamine release [1]. This case report will review a chronic tetraplegia patient who was diagnosed with TC after a severe episode of autonomic dysreflexia (AD). He experiences mild episodes of AD several times a day; however, he had never experienced the severity of symptoms that was associated with this episode which led to his hospitalization. Autonomic dysreflexia is a syndrome of imbalanced sympathetic input secondary to loss of descending central sympathetic control in spinal cord injury due to noxious stimuli below the level of the injury, which occurs when the injury level is at thoracic level 6 (T6) or above [2].

Findings: In this specific case, it is presumed that the massive catecholamine release associated with this severe AD episode resulted in TC. Although TC has been diagnosed after other instances of acute stress, it is unknown for it to be diagnosed after AD in a chronic setting.

Clinical Relevance: The long-term effects of AD have not been well studied, and this case illustrates the importance of education to recognize and manage AD in the spinal cord patient who frequently has episodes of AD.

语境：Takotsubo 心肌病 (TC) 是一种短暂的应激性心肌病，伴有不明病因的左心室功能障碍。一个公认的 TC 病理生理学理论归因于大量的儿茶酚胺释放 [1]。本病例报告将回顾一名慢性四肢瘫痪患者，该患者在严重的自主神经反射异常 (AD) 发作后被诊断为 TC。他每天都会经历几次轻微的 AD 发作；然而，他从未经历过与导致他住院的这一事件相关的严重症状。自主神经反射障碍是一种交感神经输入不平衡综合征，继发于脊髓损伤时由于损伤平面以下的有害刺激而失去下行中枢交感神经控制，当损伤平面在胸椎 6 级 (T6) 或以上时发生 [2 ]。

结果：在这个特定的案例中，推测与这种严重的 AD 事件相关的大量儿茶酚胺释放导致了 TC。尽管 TC 是在其他急性应激事件后被诊断出来的，但在慢性环境中 AD 后诊断它是未知的。

临床相关性： AD 的长期影响尚未得到很好的研究，该案例说明了对经常发生 AD 的脊髓患者进行识别和管理 AD 的教育的重要性。