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Recurrent Takotsubo Cardiomyopathy Due to Benzodiazepine Withdrawal
Shamin Hayat Mahmud1, Radisa Tosanovic1, Kyra Deep1
1University Hospitals Cleveland Medical Center, Cleveland, Ohio, USA.
Background:
Takotsubo cardiomyopathy (TCM) is a rare cause of acutely decompensated heart failure among patients without pre-existing chronic heart failure. We present a case of recurrent TCM attributed to benzodiazepine withdrawal.
Case Summary:
A 40-year-old woman with prior TCM and reverse TCM was admitted for cardiogenic shock after having recently changed her benzodiazepine regimen. She was emergently cannulated for venoarterial extracorporeal membrane oxygenation; transthoracic echocardiography showed an ejection fraction of 10% to 15% with apical hypokinesis. Intra-aortic balloon pump was added as a bridge to decannulation. Her ejection fraction recovered to 60% on discharge.
Discussion:
Benzodiazepine withdrawal-induced TCM is sparsely reported in the literature, and to our knowledge, no reports of benzodiazepine withdrawal-induced TCM requiring extracorporeal membrane oxygenation have been documented.
Take-Home Message:
It is important to recognize the echocardiographic patterns of TCM, consider benzodiazepine withdrawal, and understand the role of mechanical cardiac support in TCM-induced cardiogenic shock.
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