Assault-induced Takotsubo cardiomyopathy associated with persisting anterograde amnesia and myopathy

Abstract

Takotsubo cardiomyopathy is characterized by transient left ventricular dysfunction, electrocardiographic changes, and minimal release of myocardial enzymes that mimic acute myocardial infarction in patients without coronary artery disease. Takotsubo cardiomyopathy is frequently triggered by emotional or physical stress and occurs primarily in post-menopausal women. The pathomechanism of Takotsubo cardiomyopathy is, so far, unknown. Stress-induced amnesia is probably induced by perturbation of the hippocampal function. Assault-induced Takotsubo cardiomyopathy associated with amnesia has not been reported so far. In a 77-year-old Caucasian female, hospitalized because of confusion, anterograde amnesia, and hypertension after she had been assaulted by a female who sneaked up to her when she was unlocking the door of her apartment, Takotsubo cardiomyopathy was diagnosed based on clinical findings, electrocardiography, echocardiography, and coronary angiography. Follow-up after 8 weeks showed a regression of electrocardiographic and echocardiographic abnormalities; the amnesia for the assault, however, remained unchanged. This case shows that Takotsubo cardiomyopathy may be triggered by emotional stress induced during an assault. Assault-induced stress may not only induce Takotsubo cardiomyopathy but also amnesia for some of the events that occurred during the act.

Takotsubo Cardiomyopathy in a Jeweler Following a Hold‐up: Forensic Considerations

“…TTC is triggered by emotional or physical stress, but this syndrome remains relatively unknown in the forensic literature. We found no publications linking physical restraint with TTC and only two cases have been reported in a medicolegal context: in an elder abuse case and following a physical assault . Although our case was not the classic example of a postmenopausal woman, we noted three known features of TTC: absence of previous cardiac disease history, presence of a clear triggering factor, and brief time continuum between the assault and the onset of symptoms.…”

Simultaneous occurrence of transient global amnesia and takotsubo syndrome triggered by caring for a terminally ill relative

“…Stöllberger [3] 2010 77/f Assault Few hours Grautoff [4] 2012 69/f Health problems of the daughter 24 hours Bobinger [5] 2013 62/f Visit to a public swimming pool Few hours Toussi [6] 2014 66/f Witnessing sister's death Immediately Quick [7] 2015 57/f Son died in a car accident 2 weeks Sajeev [8] 2017 60/f Anniversary of the death of a loved one Few hours Stöllberger [9] 2018 57/f Existential fear 1 week Pyle [10] 2018 59/f Anxiety attack Few hours Finsterer [11] 2019 64/m Funeral of brother Few hours Tso [12] 2019 62/f Death of a family member, recent family court case One year Papadis [13] 2022 75/f Job meeting Immediately Dziewierz [14] 2023 64/f Acute emotional stress event Few hours…”

“…[2] Emotional and physical stressors play a role as triggers for TGA and TTS, and coincidence of both conditions has been reported (Table ). [3] [14] In a cross-sectional study of US hospitalizations, from 2006 to 2014, there were 155,105 diagnoses of TTS. TTS was associated with TGA with an odds ratio of 2.3 (95% confidence interval 1.5-3.6).…”

Simultaneous occurrence of transient global amnesia and Takotsubo syndrome triggered by caring for a terminally ill relative

“…2 Emotional and physical stressors play a role as triggers for TGA and TTS, and coincidence of both conditions has been reported (Table 1). [3][4][5][6][7][8][9][10][11][12][13][14] In a cross-sectional study of US hospitalizations from 2006 to 2014, there were 155,105 diagnoses of TTS. TTS was associated with TGA with an odds ratio of 2.3 (95% confidence interval 1.5-3.6).…”