Triptan-induced takotsubo syndrome: a case report.

Area of Science:

• Cardiology
• Pharmacology
• Neurology

Background:

• Takotsubo syndrome (TS) presents as acute systolic dysfunction, mimicking myocardial infarction.
• TS is often linked to significant emotional or physical stress, causing a catecholamine surge.
• Certain pharmacological agents are recognized as potential triggers for Takotsubo syndrome.

Observation:

• A 67-year-old woman with a history of migraines, dyslipidemia, and type II diabetes presented with chest heaviness.
• Symptoms occurred shortly after the administration of rizatriptan for acute migraine treatment.
• Electrocardiogram showed T wave inversion, and hs-troponin T levels were elevated, suggesting cardiac injury.

Findings:

• Cardiac imaging, including echocardiogram, coronary angiography, and cardiac magnetic resonance imaging, confirmed the diagnosis of Takotsubo syndrome.
• No emotional or physical stressor was identified as a trigger in this patient.
• A strong temporal association was observed between rizatriptan use and the onset of chest pain consistent with TS.

Implications:

• Rizatriptan, a common migraine medication, should be considered a potential trigger for Takotsubo syndrome.
• This case underscores the need for clinicians to investigate medication history in patients presenting with symptoms suggestive of TS, especially in the absence of typical stressors.
• Further research may be warranted to explore the specific mechanisms by which triptans can induce Takotsubo syndrome.