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Case Reports
. 2016 Jul;8(7):312-5.
doi: 10.4103/1947-2714.187153.

Selective Serotonin-norepinephrine Reuptake Inhibitors-induced Takotsubo Cardiomyopathy

Rahul Vasudev  1 , Upamanyu Rampal  2 , Hiten Patel  2 , Kunal Patel  2 , Mahesh Bikkina  2 , Fayez Shamoon  2
Affiliations
Case Reports

Selective Serotonin-norepinephrine Reuptake Inhibitors-induced Takotsubo Cardiomyopathy

Rahul Vasudev et al. N Am J Med Sci. 2016 Jul.

Abstract

Context: Takotsubo translates to "octopus pot" in Japanese. Takotsubo cardiomyopathy (TTC) is characterized by a transient regional systolic dysfunction of the left ventricle. Catecholamine excess is the one most studied and favored theories explaining the pathophysiology of TTC.

Case report: We present the case of a 52-year-old Hispanic female admitted for venlafaxine-induced TTC with a review literature on all the cases of Serotonin-norepinephrine reuptake inhibitors (SNRI)-associated TTC published so far.

Conclusion: SNRI inhibit the reuptake of catecholamines into the presynaptic neuron, resulting in a net gain in the concentration of epinephrine and serotonin in the neuronal synapses and causing iatrogenic catecholamine excess, ultimately leading to TTC.

Keywords: Apical ballooning syndrome; Takotsubo cardiomyopathy; selective serotonin-norepinephrine reuptake inhibitors; stress-induced cardiomyopathy.

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Figures

Figure 1
Figure 1
Electrocardiogram showing sinus tachycardia at 118/min with diffuse symmetric T wave inversions in limb and precordial leads but no ST segment changes
Figure 2
Figure 2
Cardiac catheterization showing normal coronaries. (Panel A) Left ventriculogram in right anterior oblique projection showing diffuse ballooning of the left ventricular apex in diastole
Figure 3
Figure 3
(Panel B) Dyskinetic base in systole
Figure 4
Figure 4
Echocardiographgy 4 chamber view showing akinesis and ballooning of the apical segment and hyperactive base of the left ventricle diastole (Panel B) and systole
See this image and copyright information in PMC

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