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Hydroxycut^®, an herbal supplement used for weight loss, is known to be associated with multiple side effects with cardiac dysrhythmias being amongst the rarer events. In this case, we report a 69-year-old female presenting after her first dose of Hydroxycut Max^® supplement resulting in an atypical variant of Takotsubo cardiomyopathy. She presented with symptoms concerning acute coronary syndrome and rapid hemodynamic compromise. Her coronary angiogram showed no obstructive coronary artery disease. The left ventriculogram and transesophageal echocardiogram were suggestive of mid ventricular Takotsubo cardiomyopathy.

We further discuss, with the aid of current literature, how caffeine and robusta coffee bean extract, two ingredients in Hydroxycut^® products can lead to increased sympathetic tone of the myocardium and decreased myocardial perfusion potentially triggering her cardiomyopathy. This will be the first reported case of Hydroxycut^® induced Takotsubo cardiomyopathy in literature.