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Takotsubo cardiomyopathy in children
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
Summary
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.
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