Takotsubo cardiomyopathy in children

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Prithvi Sendi1,2, Paul Martinez1,2, Madhuradhar Chegondi3

  • 1Division of Critical Care Medicine, Nicklaus Children's Hospital & Department of Pediatrics, Miami, FL, USA.

Cardiology in the Young
|August 27, 2020
PubMed

Insights

Takotsubo cardiomyopathy is rare in children, affecting adolescent males most often. This condition has a 7% mortality rate and is linked to psychiatric disorders and substance abuse.

Area of Science:

  • Pediatric Cardiology
  • Cardiovascular Epidemiology
  • Critical Care Medicine

Background:

  • Takotsubo cardiomyopathy (TTC), also known as stress-induced cardiomyopathy, is increasingly recognized in adults.
  • Epidemiological data and clinical outcomes of TTC in pediatric populations remain limited.

Purpose of the Study:

  • To investigate the epidemiology and clinical outcomes of takotsubo cardiomyopathy in children and adolescents.
  • To identify risk factors and demographic characteristics associated with TTC in the pediatric population.

Main Methods:

  • Retrospective analysis of the Healthcare Cost and Utilization Project Kids' Inpatient Database (2012 and 2016).
  • Identification of patients aged 1 month to 20 years diagnosed with TTC using ICD-9 (429.83) and ICD-10 (I51.81) codes.
  • Multivariable regression analysis to determine predictors of mortality.

Main Results:

  • TTC occurred in 3.1 per 100,000 pediatric discharges.
  • The majority of affected patients were adolescent males (55.0%), white (62.4%), and diagnosed with psychiatric disorders (46%) or substance use disorders (36.2%).
  • Overall mortality was 7%, with anoxic injury significantly increasing mortality risk (OR=34.42).

Conclusions:

  • Takotsubo cardiomyopathy is an uncommon but serious condition in children, predominantly affecting adolescent males.
  • Co-existing psychiatric disorders and substance use disorders are prevalent in pediatric TTC cases.
  • TTC should be considered in pediatric patients presenting with cardiac dysfunction, especially those with a history of psychiatric conditions or substance abuse.
Abstract

Keywords:
Kids’ Inpatient DatabaseTakotsubo cardiomyopathycardiomyopathychildheart failuremortality

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