Risk Factors and Management of Takotsubo Cardiomyopathy

Khalid, Sidra; Khalid, Aariez; Maroo, Praful

doi:10.7759/cureus.2626

Cited by 6 publications

(5 citation statements)

References 5 publications

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“…Nogi et al reported a mid-ventricular variant takotsubo cardiomyopathy case associated with cannabinoid hyperemesis syndrome (recurrent episodes of severe nausea and vomiting, and colicky abdominal pain associated with long-term, heavy cannabis use) in a long-term marijuana user [ 140 ]. Khalid et al reported a case of Takotsubo cardiomyopathy associated with a urine drug screen positive for THC [ 141 ]. A study performed by Alliu et al to investigate the association of cannabis and Takotsubo cardiomyopathy concluded that there is a significant association between non-dependent cannabis use and increased odds of Takotsubo cardiomyopathy [ 142 ].…”

Section: Cannabis Poisoningmentioning

confidence: 99%

Cannabis: A Toxin-Producing Plant with Potential Therapeutic Uses

Breijyeh

Jubeh

Bufo

et al. 2021

Toxins

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For thousands of years, Cannabis sativa has been utilized as a medicine and for recreational and spiritual purposes. Phytocannabinoids are a family of compounds that are found in the cannabis plant, which is known for its psychotogenic and euphoric effects; the main psychotropic constituent of cannabis is Δ9-tetrahydrocannabinol (Δ9-THC). The pharmacological effects of cannabinoids are a result of interactions between those compounds and cannabinoid receptors, CB1 and CB2, located in many parts of the human body. Cannabis is used as a therapeutic agent for treating pain and emesis. Some cannabinoids are clinically applied for treating chronic pain, particularly cancer and multiple sclerosis-associated pain, for appetite stimulation and anti-emesis in HIV/AIDS and cancer patients, and for spasticity treatment in multiple sclerosis and epilepsy patients. Medical cannabis varies from recreational cannabis in the chemical content of THC and cannabidiol (CBD), modes of administration, and safety. Despite the therapeutic effects of cannabis, exposure to high concentrations of THC, the main compound that is responsible for most of the intoxicating effects experienced by users, could lead to psychological events and adverse effects that affect almost all body systems, such as neurological (dizziness, drowsiness, seizures, coma, and others), ophthalmological (mydriasis and conjunctival hyperemia), cardiovascular (tachycardia and arterial hypertension), and gastrointestinal (nausea, vomiting, and thirst), mainly associated with recreational use. Cannabis toxicity in children is more concerning and can cause serious adverse effects such as acute neurological symptoms (stupor), lethargy, seizures, and even coma. More countries are legalizing the commercial production and sale of cannabis for medicinal use, and some for recreational use as well. Liberalization of cannabis laws has led to increased incidence of toxicity, hyperemesis syndrome, lung disease cardiovascular disease, reduced fertility, tolerance, and dependence with chronic prolonged use. This review focuses on the potential therapeutic effects of cannabis and cannabinoids, as well as the acute and chronic toxic effects of cannabis use on various body systems.

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Section: Cannabis Poisoningmentioning

confidence: 99%

Cannabis: A Toxin-Producing Plant with Potential Therapeutic Uses

Breijyeh

Jubeh

Bufo

et al. 2021

Toxins

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“…However, there have been further wall motion abnormalities in TTC described, such as basal, midventricular, and lateral akinesia of the left ventricular myocardium and also involvement of the right ventricular myocardium as part of a biventricular involvement or isolated right ventricular wall motion abnormality (3). Typically, TTC patients present with clinical symptoms suggestive for an acute coronary syndrome (ACS), such as chest pain, dyspnea, syncope, and nausea with sudden onset after an emotional or physical stressor (4). From an epidemiological point of view patients diagnosed with TTC are typically postmenopausal female patients with a mean age of 66.8 years (5, 6).…”

Section: Introductionmentioning

confidence: 99%

Takotsubo Cardiomyopathy—Acute Cardiac Dysfunction Associated With Neurological and Psychiatric Disorders

Buchmann

Lehmann

Stevens³

2019

Front. Neurol.

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Takotsubo cardiomyopathy (TTC) is an acute and reversible cardiac wall motion abnormality of the left myocardium. Although many studies focused on etiology, diagnostic and treatment of TTC, precise clinical guidelines on TTC are not available. Research revealed emotional and physical triggering factors of TTC and emphasized the association of TTC with psychiatric and particularly acute neurological disorders. Similar clinical presentation of acute coronary syndrome (ACS) and TTC patients, makes an anamnestic screening for TTC risk factors necessary. In psychiatric anamnesis affective disorders and chronic anxiety disorders are presumably for TTC. Subarachnoid hemorrhages and status epilepticus are typical acute neurological associated with a higher risk for TTC. Moreover, magnetic resonance imaging (MRI) studies reveled brain alterations of the limbic system and reduced connectivity of central autonomic nervous system structures. Diagnosis of TTC is made by elevation of cardiac enzymes, electrocardiogram (ECG) and visualization of myocardial wall motion. Major differential diagnoses like acute coronary syndrome and myocarditis are hereby in synopsis with anamnesis with respect of possible emotional and physical triggering factors of TTC ruled out. In most cases the TTC typical wall motion abnormalities resolve in weeks and therapy is only necessary in hemodynamic instable patients and if rare complications, like cardiac wall ruptures occur. Recently, the two-parted International expert consensus document on Takotsubo syndrome was published, providing a detailed characterization of TTC and allows clinicians to understand this cardiac dysfunction with a multidisciplinary view.

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“…The associated risk factors for the patient are the age of greater than 55 years, smoking, alcohol abuse, anxiety states, and hyperlipidemia [9]. Our patient may have developed TTS secondary to heightened stress, high cannabis consumption, and vertebral dissection.…”

Section: Discussionmentioning

confidence: 99%

Vertebral Artery Dissection and Takotsubo Syndrome Associated with Marijuana Use

Sánchez-Nadales

Anampa-Guzmán

2019

Cureus

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Cervical artery dissection is an intimal tear in a cervical artery with the development of intramural hematoma resulting in stenosis, occlusion, or aneurysmal dilation. Takotsubo syndrome (TTS) is characterized by acute heart failure with a distinctive regional left ventricular contraction profile. We presented the case of a 33-year-old male who visited the emergency department due to right-sided arm/leg weakness, slurred speech and transient loss of right eye vision. The patient was diagnosed with vertebral artery dissection and TTS complicated with community-acquired pneumonia. Only other case has been reported of TTS with bilateral vertebral artery dissection. TTS is a disease triggered by physical or emotional stressors. It can be confused with acute myocardial infarction and should be disoriented for the appropriate management. The prognosis is generally favorable.

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Risk Factors and Management of Takotsubo Cardiomyopathy

Cited by 6 publications

References 5 publications

Cannabis: A Toxin-Producing Plant with Potential Therapeutic Uses

Cannabis: A Toxin-Producing Plant with Potential Therapeutic Uses

Takotsubo Cardiomyopathy—Acute Cardiac Dysfunction Associated With Neurological and Psychiatric Disorders

Vertebral Artery Dissection and Takotsubo Syndrome Associated with Marijuana Use

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