Case report: Cocaine-induced takotsubo cardiomyopathy

Stress Cardiomyopathy Diagnosis and Treatment

“…Few case reports have been published, and some common characteristics seem to be related to this age group. Most cases were associated with drug abuse, alcohol, and marijuana (52,62,117) and stimulants (cocaine [118] and methamphetamines [119]), or withdrawal from substances such as alcohol (120)(121)(122) and opioids (123,124), highlighting the importance for emergency physicians to be aware of this when assessing younger patients with HF. Young women presented also a higher rate of psychiatric comorbidities and a greater propensity for recurrence in a series (125).…”

Cardiac Arrest (CA) as the Initial Presentation of Cocaine-Induced Takotsubo Cardiomyopathy (TCM): A Case Report and Review of Literature

“…About 1%-3% of all acute coronary syndromes and 5%-6% of ST-segment elevation myocardial infarction (STEMI) in women have been eventually diagnosed as TCM [22]. Cocaine use is a rare cause of TCM with only a handful of cases documented [8][9][10][11][12]. Despite its rarity, cocaine-induced TCM is a significant concern due to its potential for serious morbidity and mortality.…”

“…TCM is characterized by transient left ventricular wall dysfunction that is often triggered by physical or emotional stressors and often misdiagnosed as acute coronary syndrome [7]. Cocaine-induced TCM is even rarer as to date only a few case reports have been documented [8][9][10][11][12][13]. Herein, we present a unique case report of a 54-year-old male who developed Takotsubo cardiomyopathy (TCM) following recent cocaine use presenting with cardiac arrest (CA).…”

Takotsubo Cardiomyopathy After Cocaine Intoxication: A Case Report

“…TCM which is also referred to as stress cardiomyopathy or left ventricular apical ballooning syndrome was first reported in Japan in 1991 by Sato et.al [ 4 ] . The pathophysiology behind TCM includes the sympathetic excitation of the central nervous system that triggers the release of catecholamines and results in apical systolic dysfunction and hyperdynamic basal contraction [ 5 ] . Several hypotheses have been proposed to describe the mechanism of TCM after a catecholamine surge, including myocardial injury caused either directly via cyclic AMP mediated calcium overload or indirectly by endothelial dysfunction and myocyte damage induced by catecholamine [ 6 ] .…”

“…The treatment of TCM should be directed towards improvement of cardiac function and reduction of the risk of heart failure. Beta-blockers and angiotensin-converting enzyme inhibitors are generally used [ 5 ] . Counseling on drug addiction and detoxification are required since cessation of cocaine use have been shown to improve cardiac function.…”