Anxiety disorders and stressful events in Takotsubo syndrome

Abstract

Background: Anxiety disorders are more common in Takotsubo syndrome (TS) than in acute coronary syndrome patients. The aim of this study was to investigate whether pre-existing anxiety disorders predispose to TS triggered by exclusively emotional stressful events. Methods: Triggering events were compared in 58 TS patients with and without pre-existing anxiety disorders; clinical, electrocardiographic and echocardiographic data were also collected. Results: Thirty-one (53%) patients had a previous history of anxiety disorders. The exclusively emotional stressful event-rate was higher in TS patients with pre-existing anxiety disorder (74% vs. 30%, p = 0.001), while TS caused by an undetermined trigger were significantly higher in patients without anxiety disorders (33% vs. 10%, p = 0.027). Moreover, in TS patients without a previous history of anxiety disorders, a trend of higher prevalence of physical events was found (16% vs. 37%, p = 0.07). Conclusions:In patients with pre-existing anxiety disorders, TS was predominantly triggered by exclusively emotional stressful events, thereby suggesting a possible relationship between anxiety and emotional cardiac frailty in TS patients. (Cardiol J 2018; 25, 4: 495-500)

Traumatic Events, Personality and Psychopathology in Takotsubo Syndrome: A Systematic Review

“…Even though there were methodological disparities in the way data were collected (retrospective data by review of medical records vs. prospective assessment by standardized questionnaire at hospitalization), life-time anxiety disorders might be hypothesized to have a role in TTS. Interestingly, a recent study (Lazzeroni et al, 2018) found that only patients with pre-existing anxiety disorders were at risk of TTS triggered by emotional stressful events. This finding may help to explain why only some patients experience a stressful event as trigger of TTS.…”

Recurrent Tako-Tsubo Syndrome following repeated similar road traffic accidents

“…After an emotional stressful event, patients with anxiety can experience acute cardiac and vascular sympathetic hyper-activation. This autonomic dysfunction can make patients more susceptible to TS [12]. The prevalence of anxiety disorders in patients with TS has been reported as between 26% to 56% of patients [13].…”

“…In this study, an RTA was categorised as a traumatic physical disorder [12]. The distinction between emotional and physical triggers can be diffi cult, as physical disorders may also cause emotional stress.…”

The Association Between Hyperlipidemia and In-Hospital Outcomes in Takotsubo Cardiomyopathy

“…The variables in our study include patient demographics (age, sex, race, household income, primary payer for the hospitalization) and hospital demographics (hospital type, hospital size and region). To further reduce selection bias, we included common cardiovascular comorbidities, such as smoking, hypertension, obstructive sleep apnea (OSA), peripheral artery disease (PAD), and other reported risk factors for TCM including chronic obstructive pulmonary disease (COPD), 21,22 anxiety 23 and depressive disorders, 18 obesity, 24 diabetes mellitus (DM), 25 chronic kidney disease (CKD) 26 and sepsis. 27 In-Hospital Outcomes…”