Logo American Journal of Case Reports

Call: 1.631.629.4328
Mon-Fri 10 am - 2 pm EST

Contact Us

Logo American Journal of Case Reports Logo American Journal of Case Reports Logo American Journal of Case Reports

08 June 2020 : Case report  USA

Recurrent Takotsubo Cardiomyopathy: Getting to the Root of the Problem

Challenging differential diagnosis, Unusual or unexpected effect of treatment, Rare disease, Educational Purpose (only if useful for a systematic review or synthesis)

Matthew A. Tunzi1ABCDEFG*, Laith Dinkha2ACDEF, Alec J. Sharp2ABCDEF, Rosco S. Gore2ABCDEF

DOI: 10.12659/AJCR.923067

Am J Case Rep 2020; 21:e923067

Abstract

BACKGROUND: While takotsubo cardiomyopathy (TC) is a rare cardiomyopathy, recurrent takotsubo cardiomyopathy (rTC) is even more so, occurring in only 4% of patients with TC. Treatment is based on expert opinion and includes standard heart failure treatment using beta blockers (BB) and angiotensin-converting enzyme inhibitors (ACEI). We present a case of rTC demonstrating how using a selective serotonin reuptake inhibitor (SSRI) with cognitive behavioral therapy (CBT) can successfully prevent recurrence.

CASE REPORT: A 64-year-old woman presented with ST-elevation myocardial infarction, and coronary angiography demonstrated non-obstructive coronary artery disease. Left heart catheterization showed apical hypokinesis with preserved function of the basal segments, consistent with TC. She reported having experienced multiple emotional stressors. The patient was started on BB and ACEI, and 5 months later repeat imaging showed resolution of her TC. One month after resolution, she was re-admitted for chest pressure, and imaging demonstrated rTC. This time, in addition to continued conventional therapy, she was started on an SSRI and CBT. Nearly 6 months later, her rTC had resolved.

CONCLUSIONS: Anxiety and depression are more common in patients with TC than in patients with STEMI, but there is little in the literature about the roles of SSRI and CBT in TC treatment. In fact, SSRIs are controversial since they can increase catecholamine concentration, which some experts believe contributes to TC. The positive response of our patient to combination SSRI-CBT therapy suggests that additional research is needed on the use of this approach for prevention and treatment of rTC.

Keywords: Adrenergic beta-Antagonists, Catecholamines, Cognitive Therapy, Serotonin Uptake Inhibitors, takotsubo cardiomyopathy, Combined Modality Therapy, Coronary Angiography, Echocardiography, Recurrence, Stress, Psychological

Add Comment 0 Comments

In Press

Case report  Brazil

Successful Case of Double Valve Replacement Surgery Using Autologous Blood Transfusion: A Patient's Autonom...

Am J Case Rep In Press; DOI: 10.12659/AJCR.943675  

0:00

Case report  Saudi Arabia

Pancreatitis with Intraabdominal Venous Thrombosis as an Initial Presentation of Parathyroid Adenoma: A Rar...

Am J Case Rep In Press; DOI: 10.12659/AJCR.943838  

0:00

Case report  Singapore

Delayed-Onset Hypnopompic Visual Hallucinations 20 Years After Initiation of Propranolol Therapy for System...

Am J Case Rep In Press; DOI: 10.12659/AJCR.944342  

Case report  China (mainland)

Odontogenic Keratocyst in Maxillary Sinus with Ectopic Third Molar: A Case Report

Am J Case Rep In Press; DOI: 10.12659/AJCR.944543  

Most Viewed Current Articles

07 Mar 2024 : Case report  USA 39,654

Neurocysticercosis Presenting as Migraine in the United States

DOI :10.12659/AJCR.943133

Am J Case Rep 2024; 25:e943133

0:00

10 Jan 2022 : Case report  Germany 31,349

A Report on the First 7 Sequential Patients Treated Within the C-Reactive Protein Apheresis in COVID (CACOV...

DOI :10.12659/AJCR.935263

Am J Case Rep 2022; 23:e935263

23 Feb 2022 : Case report  USA 18,313

Penile Necrosis Associated with Local Intravenous Injection of Cocaine

DOI :10.12659/AJCR.935250

Am J Case Rep 2022; 23:e935250

19 Jul 2022 : Case report  Saudi Arabia 18,005

Atlantoaxial Subluxation Secondary to SARS-CoV-2 Infection: A Rare Orthopedic Complication from COVID-19

DOI :10.12659/AJCR.936128

Am J Case Rep 2022; 23:e936128

Your Privacy

We use cookies to ensure the functionality of our website, to personalize content and advertising, to provide social media features, and to analyze our traffic. If you allow us to do so, we also inform our social media, advertising and analysis partners about your use of our website, You can decise for yourself which categories you you want to deny or allow. Please note that based on your settings not all functionalities of the site are available. View our privacy policy.

American Journal of Case Reports eISSN: 1941-5923
American Journal of Case Reports eISSN: 1941-5923