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Published on: April 11, 2019
Unexpected Heartbreak: A Case Report of Takotsubo Cardiomyopathy Triggered by Electroconvulsive Therapy
Faeghe Hosseini1, Amir Ghaffari Jolfayi2, Mehdi Sheibani3
1Department of Cardiology, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Insights
Electroconvulsive therapy (ECT) may increase the risk of Takotsubo cardiomyopathy, a type of heart failure. Patients experiencing chest pain or ECG changes after ECT require careful cardiac evaluation.
Area of Science:
- Cardiology
- Neurology
- Psychiatry
Background:
- Electroconvulsive therapy (ECT) is a treatment for major depressive disorder.
- Takotsubo cardiomyopathy (TCM) is a form of non-ischemic heart failure.
- The association between ECT and TCM is not well-established.
Abstract:
A 73-year-old woman who suffered from major depressive disorder was candidated to receive electroconvulsive therapy (ECT) in combination with medical treatment. Shortly after ECT, she complained of severe chest pain. ECG findings revealed new QRS widening and ST-segment elevation in anterior leads, and echocardiography revealed anteroapical wall akinesia and reduced ejection fraction. Epicardial coronary arteries were normal in emergent coronary angiography, and the diagnosis of Takotsubo cardiomyopathy was considered. In addition, Troponin I was also elevated. The patient had a good recovery after medical treatment for heart failure, and the ejection fraction in echocardiography improved in a few days. This studied case demonstrates the increasing risk of Takotsubo cardiomyopathy following ECT, which needs special attention for patients with chest pain and ECG abnormalities after ECT.
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