| Takotsubo Cardiomyopathy Associated with Chronic Psychiatric Stress in Major Depressive Disorder in an Elderly Patient |
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Jung A Koh, Seon Jae Kim, Hak Cheol Lee, Seong Taek Chu, Yong Chul Shin, Jung Ju Sir, Seung Min Choi, Shin Bae Joo |
1Department of Internal Medicine, National Medical Center, Seoul, Korea. seo0515@medimail.co.kr
2Cardiovascular Center, National Medical Center, Seoul, Korea. |
| 노인 환자에서 주요 우울증의 만성 스트레스와 관련된 Takotsubo 심근병증 1예 |
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고정아1,2, 김선재1,2, 이학철1,2, 주성택1,2, 신용철2, 서정주1,2, 최승민1,2, 주신배1,2 |
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국립중앙의료원 순환기내과1, 심혈관센터2 |
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| Abstract |
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Takotsubo cardiomyopathy (TC) is a transient form of acute heart failure that most often occurs in postmenopausal women, typically triggered by a preceding emotional or physical stressor. A 74-year-old woman who suffered from chronic psychiatric stress visited National Medical Center for dyspnea. Acute emotional or physical stress could not be identified despite careful history taking. An electrocardiogram showed diffuse T-wave inversions with prolonged QT interval, and the echocardiogram showed akinesia of mid and apical segments of the left ventricle with hyperkinesia at the base. There was no significant stenosis on coronary angiography. Differing from the typical case of TC, which follows acute stress triggers, our case indicates that underlying chronic psychiatric illness exacerbation can lead to TC. We suggest that cardiologists and psychiatrists be aware of this predisposition to TC, especially in the circumstances of acute heart failure. |
| Key Words:
Left ventricle, Cardiomyopathy, Psychiatric illness |
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