Triptan-induced takotsubo syndrome: a case report

Takotsubo syndrome (TS) is a clinical condition mimicking acute coronary syndrome characterized by reversible acute systolic dysfunction. TS is typically associated with a catecholaminergic surge resulting from physical or emotional stress while some pharmacologic agents may act as a trigger.

Here, we report a case of TS secondary to rizatriptan, used for treatment of acute migraine. A 67-year-old woman with a history of dyslipidemia, type II diabetes, and migraine was admitted with chest heaviness shortly after taking rizatriptan for migraine. Deepening T wave inversion was seen in multiple territories on electrocardiogram and hs-troponin T was elevated. Cardiac imaging including echocardiogram coronary angiography and cardiac magnetic resonance imaging was consistent with a diagnosis of TS.

In this case, there was no emotional trigger for TS described. Given the compelling temporal correlation between the onset of typical chest pain and medication use, a diagnosis of TS secondary to rizatriptan was made.