Delayed multifocal recurrent stress-induced cardiomyopathy after antidepressants withdrawal

Marabotti, C; Venturini, Elio; Marabotti, Alberto; Pingitore, Alessandro

doi:10.1016/j.hrtlng.2014.03.003

Cited by 8 publications

(5 citation statements)

References 25 publications

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“…However, there are multiple reports of psychotropic agent withdrawal or overdose in addition to electroconvulsive therapy triggering TC in patients with psychiatric illness. [9][10][11] Careful management of psychotropic medications and understanding that cardiomyopathy may be triggered by electroconvulsive therapy is likely appropriate in the care of patients with ongoing psychiatric illness and a history of TC.…”

Section: Discussionmentioning

confidence: 99%

Pre-existing Psychiatric Illness is Associated With Increased Risk of Recurrent Takotsubo Cardiomyopathy

et al. 2017

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Section: Discussionmentioning

confidence: 99%

Pre-existing Psychiatric Illness is Associated With Increased Risk of Recurrent Takotsubo Cardiomyopathy

et al. 2017

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“…[21][22][23][24][25] Two cases of withdrawal from the antispasmodic baclofen and 1 case of antidepressant withdrawal leading to TCM were also reported. [26][27][28]…”

Section: Discussionmentioning

confidence: 99%

The Connection Between Opioid Withdrawal and Takotsubo Cardiomyopathy: Case Reports of ‘Opioid Octopus Heart’

Hack

Ojeniyi

Mamzhi

et al. 2022

Georgetown Medical Review

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Case PresentationsHere, we present 2 cases of TCM in patients who chronically used opioids, both at the same institution within 1 month of each other. The first patient is a 68-year-old man who presented with a chronic obstructive pulmonary disease exacerbation and did not disclose his long-standing opioid use disorder. One day after admission, he was found to be in opioid withdrawal and, soon after, developed TCM. He was originally treated for non-ST elevation myocardial infarction and opioid withdrawal but decompensated. He was sent to the intensive care unit (ICU) to receive pressors and fluid resuscitation. He soon recovered and his cardiac function returned to baseline. The second patient is a 33-year-old woman with opioid use disorder taking methadone who presented with lower extremity weakness, edema, and pain. She was diagnosed with infective endocarditis. While awaiting surgery and receiving antibiotics, she developed respiratory failure and was upgraded to the ICU. There was a lapse in her opioid treatment, and she subsequently developed TCM. She was treated with pressors and fluids in the ICU, and eventually recovered with reduced cardiac function at the time of discharge. ConclusionsWhile clinical evidence indicated opioid withdrawal as the likely provoking factor for development of TCM in the first case, the second patient's symptoms from other clinical complications confounded the cause of her TCM. Twelve similar cases have been reported in the literature, suggesting that opioid withdrawal may be associated with development of TCM. Further quantitative research is required to establish this relationship. Our findings contribute to the theoretical pathophysiology of TCM and offer important considerations for clinical management of opioid withdrawal.

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“…After 28 hours, she began to have symptoms of benzodiazepine withdrawal along with ST-segment elevations on EKG, with a TTE showing apical akinesis and LVEF of 45%. The second [ 5 ] described a 65-year-old woman who self-discontinued several long-term psychiatric medications, including a benzodiazepine, and then presented with syncope and a TTE suggestive of takotsubo cardiomyopathy.…”

Section: Discussionmentioning

confidence: 99%

Takotsubo Cardiomyopathy and Catatonia in the Setting of Benzodiazepine Withdrawal

Peng

Patchett

Bernard

2016

Case Reports in Cardiology

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We report two serious and unusual complications of benzodiazepine withdrawal in a single patient: takotsubo cardiomyopathy and catatonia. This 61-year-old female patient was brought to the emergency department with lethargy and within hours had declined into a state of catatonia. Although there was never a complaint of chest pain, ECG showed deep anterior T-wave inversions and cardiac enzymes were elevated. An echocardiogram was consistent with takotsubo cardiomyopathy. She later received 1 mg of midazolam and within minutes had resolution of catatonic symptoms. Careful history revealed that she had omitted her daily dose of lorazepam for 3 days prior to admission. To our knowledge, the case presented herein is the first report of simultaneous catatonia and takotsubo cardiomyopathy in the setting of benzodiazepine withdrawal. The pathogenesis of both conditions is poorly understood but may be indirectly related to the sudden decrease in γ-aminobutyric acid (GABA) signaling during benzodiazepine withdrawal.

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Delayed multifocal recurrent stress-induced cardiomyopathy after antidepressants withdrawal

Cited by 8 publications

References 25 publications

Pre-existing Psychiatric Illness is Associated With Increased Risk of Recurrent Takotsubo Cardiomyopathy

Pre-existing Psychiatric Illness is Associated With Increased Risk of Recurrent Takotsubo Cardiomyopathy

The Connection Between Opioid Withdrawal and Takotsubo Cardiomyopathy: Case Reports of ‘Opioid Octopus Heart’

Takotsubo Cardiomyopathy and Catatonia in the Setting of Benzodiazepine Withdrawal

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