Vulnerable personality and Takotsubo cardiomyopathy consequent to emotional stressful events: a clinical case report

  • Angelo Compare | angelo.compare@unibg.it University of Bergamo, Italy.
  • Riccardo Proietti Electrophysiology Laboratory, Luigi Sacco Hospital, Milano, Italy.
  • Domenico Del Forno Department of Clinical Medicine, Cardiological and Immunological Science, University of Naples Federico II, Italy.
  • Alessandra Vitelli Department of Clinical Medicine, Cardiological and Immunological Science, University of Naples Federico II, Italy.
  • Alessandra Grieco Department of Clinical Medicine, Cardiological and Immunological Science, University of Naples Federico II, Italy.
  • Luigi Maresca Department of Clinical Medicine, Cardiological and Immunological Science, University of Naples Federico II, Italy.
  • Francesco Giallauria Department of Clinical Medicine, Cardiological and Immunological Science, University of Naples Federico II, Italy.

Abstract

Introduction: Although the onset of Takotsubo cardiomyopathy (TTC) can be triggered by an acute, intense emotional stress, the exact pathogenic mechanisms still remain undefined. Presentation: A 58-year-old female was sent by ambulance to the Emergency Department (ED) for chest pain and ST elevations on ECG. Her chest pain began 3 hours before on admission after a domestic argument. Transthoracic echocardiogram showed severe systolic dysfunction with an ejection fraction of 20%. Cardiac catheterization revealed no significant coronary artery disease. The left ventriculogram showed apical ballooning with hyperdynamic proximal segments. A diagnosis of Takotsubo Cardiomyophaty (TTC) was made according to the Mayo Clinic 2008 criteria. The patient evolved with improvement of her condition and, therefore, was discharged from the hospital. Follow-up echocardiogram seven days later showed normal LV size and function with ejection fraction (EF) of 43%. Paykel Life Stress Event Scale identified as emotional trigger a domestic argument occurred 3 hours before symptom onset. History showed a major life stress event, death of a loved one, six months before symptoms. The patient underwent psychological assessment after hospital discharge by Emotional Regulation Questionnaire and BDI showing high suppression/ low reappraisal profile and moderate depression. Conclusion: This case highlights the hypothesis of a possible link between cognitive emotional processing and vulnerability to Takotsubo syndrome.

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Published
2015-12-09
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Section
Case Reports
Keywords:
Takotsubo cardiomyopathy, personality traits, stressful event, emotional regulation, emotional trigger
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How to Cite
Compare, A., Proietti, R., Del Forno, D., Vitelli, A., Grieco, A., Maresca, L., & Giallauria, F. (2015). Vulnerable personality and Takotsubo cardiomyopathy consequent to emotional stressful events: a clinical case report. Monaldi Archives for Chest Disease, 76(2). https://doi.org/10.4081/monaldi.2011.197

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