Reversible Electrocardiogram Changes and Cardiomyopathy Secondary to Baclofen Withdrawal Syndrome

Kireyev, Dmitriy; Poh, Kian‐Keong

doi:10.15420/ahhj.2010.8.1.52

Cited by 11 publications

(5 citation statements)

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“…In the majority of the cases, TTS has been described only in case reports and no prospective investigations are available. Also treatment of CNS disorders may be complicated by the development of TTS [33,34].…”

Section: Cns Disorders Inducing Ttsmentioning

confidence: 99%

“…TTS due to a serotonergic syndrome has been reported in two cases [150,151]. Baclofen withdrawal syndrome is a rare potentially life-threatening condition manifesting with high fever, seizures, spasticity, autonomic dysreflexia, and multiorgan failure [34]. Baclofen withdrawal syndrome has only been reported to have caused cardiac disease in a single patient.…”

Section: Tts Related To Treatment Of Cns Disordersmentioning

confidence: 99%

“…Baclofen withdrawal syndrome has only been reported to have caused cardiac disease in a single patient. In a patient receiving baclofen via a pump system for spasticity, TTS had developed after the discontinuation of the antispastic medication [34]. In a single case malignant neuroleptic syndrome triggered the development of TTS [152].…”

Section: Tts Related To Treatment Of Cns Disordersmentioning

confidence: 99%

See 2 more Smart Citations

CNS disease triggering Takotsubo stress cardiomyopathy

Finsterer

Wahbi

2014

International Journal of Cardiology

122

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Section: Cns Disorders Inducing Ttsmentioning

confidence: 99%

Section: Tts Related To Treatment Of Cns Disordersmentioning

confidence: 99%

Section: Tts Related To Treatment Of Cns Disordersmentioning

confidence: 99%

See 1 more Smart Citation

CNS disease triggering Takotsubo stress cardiomyopathy

Finsterer

Wahbi

2014

International Journal of Cardiology

122

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“…[21][22][23][24][25] Two cases of withdrawal from the antispasmodic baclofen and 1 case of antidepressant withdrawal leading to TCM were also reported. [26][27][28]…”

Section: Discussionmentioning

confidence: 99%

The Connection Between Opioid Withdrawal and Takotsubo Cardiomyopathy: Case Reports of ‘Opioid Octopus Heart’

Hack

Ojeniyi

Mamzhi

et al. 2022

Georgetown Medical Review

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Case PresentationsHere, we present 2 cases of TCM in patients who chronically used opioids, both at the same institution within 1 month of each other. The first patient is a 68-year-old man who presented with a chronic obstructive pulmonary disease exacerbation and did not disclose his long-standing opioid use disorder. One day after admission, he was found to be in opioid withdrawal and, soon after, developed TCM. He was originally treated for non-ST elevation myocardial infarction and opioid withdrawal but decompensated. He was sent to the intensive care unit (ICU) to receive pressors and fluid resuscitation. He soon recovered and his cardiac function returned to baseline. The second patient is a 33-year-old woman with opioid use disorder taking methadone who presented with lower extremity weakness, edema, and pain. She was diagnosed with infective endocarditis. While awaiting surgery and receiving antibiotics, she developed respiratory failure and was upgraded to the ICU. There was a lapse in her opioid treatment, and she subsequently developed TCM. She was treated with pressors and fluids in the ICU, and eventually recovered with reduced cardiac function at the time of discharge. ConclusionsWhile clinical evidence indicated opioid withdrawal as the likely provoking factor for development of TCM in the first case, the second patient's symptoms from other clinical complications confounded the cause of her TCM. Twelve similar cases have been reported in the literature, suggesting that opioid withdrawal may be associated with development of TCM. Further quantitative research is required to establish this relationship. Our findings contribute to the theoretical pathophysiology of TCM and offer important considerations for clinical management of opioid withdrawal.

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“…Acidosis may occur [115]. Cases of reversible cardiomyopathies in the setting of baclofen withdrawal have also been reported [120,121]. There is significant overlap in the clinical presentation of overdose and withdrawal (e.g., autonomic instability, coma, seizures, laboratory abnormalities), and differentiating between the two entities may be difficult [50].…”

Section: Clinical Manifestations Of Baclofen Withdrawalmentioning

confidence: 99%