Trigger factors in takotsubo syndrome – A systematic review of case reports

Takotsubo Syndrome and Inflammatory Bowel Diseases: Does a Link Exist?

“…About 90% of TTS occurs in post-menopausal women, after a stressful event [16]. It is conceivable that in our patient the fear for hospitalization and diagnostic workup induced a reactive state of anxiety, precipitating TTS.…”

“…The emotional reaction to IBD symptoms and to malnutrition is the mechanism strictly associated to the onset of anxiety and depression during disease activity phase [8,18]. On this connection, even TTS patients show a higher prevalence of anxiety and depression compared to general population [16,40], significantly influencing the disease by increasing the concentration of catecholamines [41]. All these mechanisms could trigger TTS in predisposed patients (e.g., female, elderly, with abnormal catecholamine secretion or response, etc.)…”

Heart broken twice: a case of recurrent Takatsubo cardiomyopathy

“…Classically, emotional or physical stress triggers an excessive sympathetic nervous system stimulation responsible for TTC. Nyman et al recently did a systematic review on trigger factors in TTC and found that physical factors are more common than emotional factors 1. Also, they found that most vulnerable group to have evident trigger factors leading to TTC are women ≤50 years of age and men.…”

“…Most common physical factor was illness (60%) followed by procedure/surgery-related stress (40%). Similarly, anxiety/panic attack/fear (31.6%) constituted the most common emotional trigger followed by grief/loss (23.1%) 1. Some of the commonly reported physical triggers are chronic obstructive pulmonary disease, subarachnoid haemorrhage, thyrotoxicosis, Addisonian crisis, sepsis and so on 1.…”

“…Similarly, anxiety/panic attack/fear (31.6%) constituted the most common emotional trigger followed by grief/loss (23.1%) 1. Some of the commonly reported physical triggers are chronic obstructive pulmonary disease, subarachnoid haemorrhage, thyrotoxicosis, Addisonian crisis, sepsis and so on 1. In addition, recently Amariles et al reviewed literature and reported at least 20 drugs that were recognised as possible cause for drug induced TTC 2.…”