Takotsubo Cardiomyopathy as a Complication of Electroconvulsive Therapy

Sharp, Randall P; Welch, Ellen

doi:10.1345/aph.1q393

Cited by 17 publications

(20 citation statements)

References 23 publications

(22 reference statements)

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“…This finding corroborates and expands findings of previous reports involving patients with takotsubo cardiomyopathy in the context of subarachnoid hemorrhage, 20 epilepsy, 21 electroconvulsive therapy, 22 head injury, 23 stroke, 24 and anxiety or depression. 25 Of note, the coronary microcirculation is innervated by neurons that originate in the brain stem and mediate vasoconstriction, which supports the concept that myocardial stunning due to microvascular dysfunction among patients with takotsubo cardiomyopathy 26 may be of neurogenic origin.…”

Section: Discussionsupporting

confidence: 91%

Clinical Features and Outcomes of Takotsubo (Stress) Cardiomyopathy

Templin¹,

et al. 2015

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BACKGROUND The natural history, management, and outcome of takotsubo (stress) cardiomyopathy are incompletely understood. METHODS The International Takotsubo Registry, a consortium of 26 centers in Europe and the United States, was established to investigate clinical features, prognostic predictors, and outcome of takotsubo cardiomyopathy. Patients were compared with age-and sex-matched patients who had an acute coronary syndrome. RESULTS Of 1750 patients with takotsubo cardiomyopathy, 89.8% were women (mean age, 66.8 years). Emotional triggers were not as common as physical triggers (27.7% vs. 36.0%), and 28.5% of patients had no evident trigger. Among patients with takotsubo cardiomyopathy, as compared with an acute coronary syndrome, rates of neurologic or psychiatric disorders were higher (55.8% vs. 25.7%) and the mean left ventricular ejection fraction was markedly lower (40.7±11.2% vs. 51.5±12.3%) (P<0.001 for both comparisons). Rates of severe in-hospital complications including shock and death were similar in the two groups (P=0.93). Physical triggers, acute neurologic or psychiatric diseases, high troponin levels, and a low ejection fraction on admission were independent predictors for in-hospital complications. During long-term follow-up, the rate of major adverse cardiac and cerebrovascular events was 9.9% per patient-year, and the rate of death was 5.6% per patient-year. CONCLUSIONS Patients with takotsubo cardiomyopathy had a higher prevalence of neurologic or psychiatric disorders than did those with an acute coronary syndrome. This condition represents an acute heart failure syndrome with substantial morbidity and mortality. (Funded by the Mach-Gaensslen Foundation and others; ClinicalTrials.gov number, NCT01947621.).

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Section: Discussionsupporting

confidence: 91%

Clinical Features and Outcomes of Takotsubo (Stress) Cardiomyopathy

Templin¹,

et al. 2015

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“…In the majority of the cases, TTS has been described only in case reports and no prospective investigations are available. Also treatment of CNS disorders may be complicated by the development of TTS [33,34].…”

Section: Cns Disorders Inducing Ttsmentioning

confidence: 99%

CNS disease triggering Takotsubo stress cardiomyopathy

Finsterer

Wahbi

2014

International Journal of Cardiology

119

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“…[11][12][13][14][15] It is interest ing to note that in a number of these cases the patient was man aged and ECT subsequently reat tempted. 8,11,15 One review men tioned managing resultant cases by giving beta adrenergic blockers prior to sessions. 8 Prior to commencement of the sessions, a cardiology referral was made, the cardiologist reviewed and gave the goahead for the ECT.…”

Section: Takotsubo Cardiomyopathymentioning

confidence: 99%

“…8,11,15 One review men tioned managing resultant cases by giving beta adrenergic blockers prior to sessions. 8 Prior to commencement of the sessions, a cardiology referral was made, the cardiologist reviewed and gave the goahead for the ECT.…”

Section: Takotsubo Cardiomyopathymentioning

confidence: 99%

ECT in a patient with a meningioma and Takotsubo cardiomyopathy

Gani¹,

Parvez²

2016

Prog Neurol Psychiatry

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There are few studies that look at the use of electroconvulsive therapy (ECT) in elderly patients with a comorbid meningioma or other intracranial tumour, with the dilemma being whether or not to do ECT. This case notes article examines the ECT management of an elderly lady with severe depression, coexisting Takotsubo cardiomyopathy, and an incidental finding of a frontal meningioma. The authors detail the multidisciplinary approach necessary for managing a patient with coincident psychiatric, cardiac and neurological diagnoses and the implications for practice.

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Takotsubo Cardiomyopathy as a Complication of Electroconvulsive Therapy

Cited by 17 publications

References 23 publications

Clinical Features and Outcomes of Takotsubo (Stress) Cardiomyopathy

Clinical Features and Outcomes of Takotsubo (Stress) Cardiomyopathy

CNS disease triggering Takotsubo stress cardiomyopathy

ECT in a patient with a meningioma and Takotsubo cardiomyopathy

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