Key result
Severe emotional stress triggered Takotsubo cardiomyopathy in a 43-year-old woman who presented with an unremarkable initial ECG but significantly elevated troponin levels.
Why the study?
Takotsubo cardiomyopathy is frequently associated with stress, meaning patients may present primarily to psychiatric clinics, potentially delaying diagnosis and therapy.
Case Report (n=1)
No
Takotsubo cardiomyopathy can present with an unremarkable initial ECG, highlighting the importance of concurrent troponin measurement in patients with acute psychopathology and cardio-thoracic symptoms.
Psychiatrists should evaluate chest pain in stressed patients for TCM; this case extends recognition but leaves screening protocols open.
Introduction: Takotsubo cardiomyopathy (TCM) is frequently associated with emotional or physical stress. Thus, patients with TCM might present primarily at a psychiatric clinic. Appropriate diagnosis and therapy may thus be delayed. Case report: A 43-year-old female patient presented as an emergency to the psychiatric outpatient clinic after experiencing severe work-related bullying. On admission, she complained of acute left thoracic chest pain as well as depressed mood, low energy, anhedonia, generalized anxiety, and sleep difficulties, present for several weeks. The initial electrocardiogram was unremarkable; serum troponin levels, however, were markedly elevated. The patient was transferred to the department of cardiology. Via cardiac catheterization and MRI an acute coronary syndrome was excluded and apical ballooning and left ventricular dysfunction, compatible with TCM, was found. Conclusion: Patients with acute psychopathology, recent emotional or physical stress and acute cardio-thoracic symptoms should receive immediate cardiological investigations. As the ECG may be normal in patients with TCM, concurrent measurement of the troponin serum level is recommended. Psychiatrists should consider TCM in patients, who report recent stressful events accompanied by cardio-thoracic symptoms.
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Elsayed et al. (2019) conducted a case report in Takotsubo cardiomyopathy (n=1). Emotional stress was evaluated. Severe emotional stress triggered Takotsubo cardiomyopathy in a 43-year-old woman who presented with an unremarkable initial ECG but significantly elevated troponin levels.
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