J Korean Geriatr Soc.  2015 Sep;19(3):181-184. 10.4235/jkgs.2015.19.3.181.

Takotsubo Cardiomyopathy Associated with Chronic Psychiatric Stress in Major Depressive Disorder in an Elderly Patient

• Koh JA
• Kim SJ
• Lee HC
• Chu ST
• Shin YC
• Sir JJ
• Choi SM
• Joo SB

• KMID: 2188190
• DOI: http://doi.org/10.4235/jkgs.2015.19.3.181

Abstract

Takotsubo cardiomyopathy (TC) is a transient form of acute heart failure that most often occurs in postmenopausal women, typically triggered by a preceding emotional or physical stressor. A 74-year-old woman who suffered from chronic psychiatric stress visited National Medical Center for dyspnea. Acute emotional or physical stress could not be identified despite careful history taking. An electrocardiogram showed diffuse T-wave inversions with prolonged QT interval, and the echocardiogram showed akinesia of mid and apical segments of the left ventricle with hyperkinesia at the base. There was no significant stenosis on coronary angiography. Differing from the typical case of TC, which follows acute stress triggers, our case indicates that underlying chronic psychiatric illness exacerbation can lead to TC. We suggest that cardiologists and psychiatrists be aware of this predisposition to TC, especially in the circumstances of acute heart failure.

Keyword

Left ventricle; Cardiomyopathy; Psychiatric illness

MeSH Terms

Aged*
Cardiomyopathies
Constriction, Pathologic
Coronary Angiography
Depressive Disorder, Major*
Dyspnea
Electrocardiography
Female
Heart Failure
Heart Ventricles
Humans
Hyperkinesis
Psychiatry
Takotsubo Cardiomyopathy*