scholarly journals Takotsubo Cardiomyopathy and Catatonia in the Setting of Benzodiazepine Withdrawal

2016 ◽  
Vol 2016 ◽  
pp. 1-3 ◽  
Author(s):  
Teng J. Peng ◽  
Nicholas D. Patchett ◽  
Sheilah A. Bernard
Keyword(s):  
Emergency Department ◽  
Takotsubo Cardiomyopathy ◽  
Aminobutyric Acid ◽  
Single Patient ◽  
Cardiac Enzymes ◽  
T Wave ◽  
Daily Dose ◽  
Benzodiazepine Withdrawal ◽  
Sudden Decrease ◽  
Careful History

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 inγ-aminobutyric acid (GABA) signaling during benzodiazepine withdrawal.

The three faces of takotsubo cardiomyopathy in a single patient

2019 ◽  
Vol 37 (1) ◽  
pp. 135-138 ◽  
Author(s):  
Scott E. Janus ◽  
Brian D. Hoit
Keyword(s):  
Takotsubo Cardiomyopathy ◽  
Single Patient

Myocarditis case associated with Campylobacter jejuni

2018 ◽  
Vol 43 (5) ◽  
pp. 568-570
Author(s):  
Hakan Ayyildiz ◽  
Mehmet Kalayci ◽  
Nadire Cinkilinc ◽  
Mahmut Bozkurt ◽  
Makbule Kutlu Karadag
Keyword(s):  
Emergency Department ◽  
Chest Pain ◽  
Campylobacter Jejuni ◽  
Bacterial Infections ◽  
Troponin I ◽  
Normal Sinus Rhythm ◽  
Cardiac Enzymes ◽  
Normal Sinus ◽  
Anterior Hemiblock ◽  
High Sensitive Troponin

Abstract Objective Myocarditis is an inflammatory disease of the heart caused by various agents and especially enteroviruses, and it is difficult to diagnose and treat. Myocarditis is rarely associated with bacterial infections. Although the most common bacterial infections are Salmonella spp. and Shigella spp., extremely rare cases of Myocarditis due to Campylobacter jejuni are also reported. Patient and methods A 17-year-old male patient with no previous chronic illness was admitted to our emergency department with complaints of abdominal pain, diarrhea, vomiting, and chest pain. He stated that symptoms began after eating a chicken burger a few days ago. Results In the laboratory tests performed, CK-MB and high sensitive Troponin I values were determined as 33.8 IU/L and 1816 ng/L, respectively. Electrocardiogram results revealed left axis left anterior hemiblock in the normal sinus rhythm as well as a ST-T change in the inferior and lateral derivations. Campylobacter jejuni was detected in the stool sample of the patient. Conclusion Myocarditis is one of the rare complications of C. jejuni infection. Bacterial myocarditis should be considered when troponin and cardiac enzymes are elevated in patients admitted to the emergency department with diarrhea and chest pain.

scholarly journals Takotsubo cardiomyopathy: diagnosis in an emergency department

2014 ◽  
Vol 10 (1) ◽  
Author(s):  
Marina Mancini ◽  
Davide Bartolini ◽  
Mauro Zanna
Keyword(s):  
Emergency Department ◽  
Takotsubo Cardiomyopathy

scholarly journals Takotsubo Cardiomyopathy as a Complication/ Sequelae of Prolonged Refractory Seizure: A Case Report from Nepal

2021 ◽  
Author(s):  
Bikash Khadka ◽  
Kishor Khanal
Keyword(s):  
Central Nervous System ◽  
Nervous System ◽  
Intensive Care ◽  
Case Report ◽  
Antiepileptic Drugs ◽  
Takotsubo Cardiomyopathy ◽  
Cardiac Enzymes ◽  
Recurrent Seizure ◽  
Mortality And Morbidity ◽  
Central Nervous System Disorders

Takotsubo cardiomyopathy(TC) is a reversible, yet underdiagnosed cause of mortality and morbidity in the intensive care units. It occurs secondary to sudden catecholamine surge precipitated by any form of emotional or pathological stress. Association between central nervous system disorders and Takotsubo cardiomyopathy is being increasingly reported. Epilepsy is the second most common CNS disorder to trigger TC, SAH being the first. We report a case of TC in an elderly man with prolonged, recurrent seizure episodes refractory to the commonly used antiepileptic drugs (AEDs), who developed unexplained tachycardia, hypotension and elevated cardiac enzymes.

scholarly journals Takotsubo Cardiomyopathy and Psychiatric Illness: Redefining the Relationship

2016 ◽  
Vol 5 ◽  
Author(s):  
Hannah Masoud
Keyword(s):  
Emergency Department ◽  
Takotsubo Cardiomyopathy ◽  
Psychiatric Illness ◽  
Panic Attacks ◽  
Shortness Of Breath ◽  
Model Of Care ◽  
Coronary Syndrome ◽  
Relationship Of ◽  
Anxiety Depression ◽  
The Relationship

Physicians who encounter patients in the emergency department with chest pain, palpitations, or shortness of breath may often find it difficult to differentiate diagnosis of panic attacks from acute coronary syndrome or Takotsubo Cardiomyopathy. Redefining and understanding the pathophysiological relationship of psychiatric illness including anxiety, depression, or panic attacks and Takotsubo Cardiomyopathy may help clinicians implement a more effective and beneficial model of care for this affliction that is being found to be increasingly more common in today’s age.

Authors' Response: The three faces of Takotsubo cardiomyopathy in a single patient

2020 ◽  
Vol 37 (7) ◽  
pp. 1136-1137
Author(s):  
Scott E. Janus ◽  
Eugene Chang ◽  
Brian D. Hoit
Keyword(s):  
Takotsubo Cardiomyopathy ◽  
Single Patient

scholarly journals Acute myocardial injury after administration of intravenous epinephrine for allergic reaction

2020 ◽  
Vol 8 ◽  
pp. 2050313X2093310 ◽  
Author(s):  
Katerina Zakka ◽  
Sneha Gadi ◽  
Nikoloz Koshlelashvili ◽  
Noble M Maleque
Keyword(s):  
Risk Factors ◽  
Coronary Artery Disease ◽  
Emergency Department ◽  
Coronary Artery ◽  
Myocardial Ischemia ◽  
Intravenous Administration ◽  
Myocardial Injury ◽  
T Wave ◽  
Acute Myocardial Injury ◽  
Artery Disease

Myocardial injury or infarction in the setting of anaphylaxis can be due to anaphylaxis itself, known as Kounis syndrome, or as a result of treatment with epinephrine. Myocardial ischemia caused by therapeutic doses of epinephrine in the setting of anaphylaxis is a rare event attributed to coronary artery vasospasm. A 41-year-old female with past medical history of recurrent costochondritis, chronic thrombocytopenia, and nonspecific palindromic rheumatism presented to the emergency department with perioral numbness, flushing and throat tightness after a meal containing fish and almonds. Intramuscular epinephrine was ordered but inadvertently administered intravenously, after which she developed sharp, substernal chest pain and palpitations. Electrocardiogram showed normal sinus rhythm with QT interval prolongation. Troponin peaked at 1.41 ng/mL. She was given 324 mg of aspirin in the emergency department. Transthoracic echocardiogram showed normal ejection fraction with lateral wall motion abnormality. We present a case of a patient with no significant risk factors for coronary artery disease who developed myocardial injury following inadvertent IV administration of a therapeutic dose of epinephrine for an anaphylactic-like reaction. The development of myocardial injury after epinephrine is rare, with only six reported cases in literature and just one after intravenous administration. This is the first described case of known myocardial injury without ST-T wave changes on electrocardiogram . The proposed mechanism is an alpha-1 receptor-mediated coronary vascular spasm resulting in myocardial ischemia. The aim of this case is to raise awareness of the potential for acute myocardial injury after inadvertent intravenous administration of epinephrine for anaphylaxis, even in patients with no known risk factors for coronary artery disease, as well as to demonstrate that this clinical scenario can present regardless of troponin elevation and without ST-T wave ECG changes.

scholarly journals A Case of Reverse Takotsubo Cardiomyopathy Incited by a Spinal Subdural Hematoma

2019 ◽  
Vol 2019 ◽  
pp. 1-5 ◽  
Author(s):  
Kyle Sanchez ◽  
Steven Glener ◽  
Nathan E. Esplin ◽  
Okorie N. Okorie ◽  
Amay Parikh
Keyword(s):  
Takotsubo Cardiomyopathy ◽  
Subdural Hematoma ◽  
Left Ventricular Systolic Dysfunction ◽  
Systolic Dysfunction ◽  
Apical Ballooning ◽  
Cord Compression ◽  
Left Ventricular ◽  
Cardiac Enzymes ◽  
Spinal Subdural Hematoma ◽  
Apparently Healthy

Takotsubo cardiomyopathy is a rare syndrome of transient, reversible left ventricular systolic dysfunction. It mimics myocardial infarction clinically and includes elevated cardiac enzymes, but echocardiography reveals apical ballooning and basal hyperkinesis. Infrequently, midventricular or even reverse Takotsubo patterns have been described, involving ballooning of the basal heart without the characteristic ‘Takotsubo’ appearance. There are cases in the literature that support a connection between reverse Takotsubo cardiomyopathy (r-TTC) and neurological insults as inciting factors. We report a case of r-TTC in an otherwise healthy 23-year-old man presenting with back pain, urinary retention, bradycardia, and hypertension. Troponin levels and brain natriuretic peptide (BNP) were elevated, and echocardiogram revealed an ejection fraction (EF) of less than 20%. In addition, MRI demonstrated a spinal subdural hematoma from T1-S1 with no cord compression. Repeated echocardiogram demonstrated an EF of 20-25% with a reverse Takotsubo pattern of cardiomyopathy. With supportive care, his clinical picture improved with normalization of cardiac enzyme and BNP values. This case represents a r-TTC presenting as heart failure in a young, apparently healthy male likely incited by a spinal subdural hematoma. To our knowledge, it is the first of its kind reported.

scholarly journals Electrocardiographic Abnormalities of Takotsubo Cardiomyopathy in a Patient with Paced Ventricular Rhythm

2010 ◽  
Vol 2010 ◽  
pp. 1-3 ◽  
Author(s):  
Krati Chauhan ◽  
Siva P. Sontineni ◽  
Venkata M. Alla ◽  
Mark J. Holmberg
Keyword(s):  
Takotsubo Cardiomyopathy ◽  
Significant Coronary Artery Disease ◽  
Regional Wall Motion ◽  
T Wave ◽  
Wave Inversion ◽  
Qt Interval Prolongation ◽  
Regional Wall Motion Abnormalities ◽  
St Elevation ◽  
Wall Motion Abnormalities ◽  
Artery Disease

Takotsubo cardiomyopathy (TCM) is a unique cardiomyopathy characterized by chest pain, ECG, and regional wall motion abnormalities closely mimicking acute myocardial infarction, in the absence of significant coronary artery disease. Classic ECG changes of TCM include ST elevation or T wave inversion. However, ECG abnormalities of TCM in patients with paced ventricular rhythms have not been well characterized. Herein, we report the case of an 85-year-old pacemaker dependant female who was diagnosed with TCM four weeks following the demise of her husband. Abnormal negative T wave concordance in precordial leads and QT interval prolongation were the only new ECG findings and these reverted back to baseline on followup.

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