Takotsubo cardiomyopathy in the setting of acute alcohol withdrawal

Takotsubo Cardiomyopathy (TCM), also known as stress-induced cardiomyopathy, is a cardiomyopathy characterized by acute reversible apical ventricular dysfunction and apical akinesis in the absence of obstructive coronary artery disease. Although the disease may be precipitated by an acute emotional or physical stressor, the pathophysiology, postulated to involve excess catecholamine release, remains unproven. In contrast, the role of catecholamine excess and hyperadrenergic physiology in acute alcohol withdrawal (AAW) is more established. TCM in the context of acute alcohol withdrawal has been only rarely described. The authors present a new case of TCM in the setting of AAW, along with a review of other reported cases. Current theories on the etiology of TCM and a possible pathophysiologic linkage between TCM and AAW are discussed.