Takotsubo cardiomyopathy associated with dydrogesterone use

Area of Science:

• Cardiology
• Endocrinology
• Pharmacology

Background:

• Takotsubo cardiomyopathy (TTC) is characterized by transient left ventricular apical ballooning without coronary artery disease, often triggered by emotional or physical stress.
• The condition predominantly affects postmenopausal women, leading to speculation about the role of female sex hormones in its pathogenesis.

Observation:

• This case report presents a premenopausal woman who developed Takotsubo cardiomyopathy.
• The onset of symptoms coincided with the initiation of dydrogesterone, a synthetic progestin.

Findings:

• This is the first reported instance of Takotsubo cardiomyopathy associated with dydrogesterone therapy.
• The case challenges the established link between TTC and postmenopausal status, suggesting other hormonal factors may be involved.

Implications:

• The findings suggest that synthetic progestins like dydrogesterone could potentially trigger Takotsubo cardiomyopathy, even in premenopausal women.
• Further research is warranted to explore the role of specific hormonal profiles and synthetic progestins in the development of stress-induced cardiomyopathy.