Role of Depression and Anxiety Disorders in Takotsubo Syndrome: The Psychiatric Side of Broken Heart

Oliveri, Federico; Goud, Harshit K; Mohammed, Lubna; Mehkari, Zainab; Javed, Moiz; Althwanay, Aldanah; Ahsan, Farah; Rutkofsky, Ian H

doi:10.7759/cureus.10400

Cited by 14 publications

(13 citation statements)

References 50 publications

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“…TS is diagnosed according to Mayo clinic diagnostic criteria. ECG findings of patients, who present with complaints of chest pain, shortness of breath, palpitations similar to acute myocardial infarction, reveal T negativity and ST elevation, and a moderate elevation in troponin levels occur [7]. Differential diagnosis from acute myocardial infarction can be made by angiography [8].…”

Section: Discussionmentioning

confidence: 99%

“…This condition creates the appearance of a narrow neck and apical ballooning at the end of the systole in the left ventricle. The name Takotsubo was given because the appearance of the heart in echocardiography was compared to the shape of the container the Japanese used to catch octopus [7]. Although TS is thought to have a relatively benign prognosis, ventricular fibrillation can be observed in cardiogenic shock [7].…”

Section: Discussionmentioning

confidence: 99%

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Takotsubo syndrome triggered by emotional stress: a case report

Mulayim

2022

The European Research Journal

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Takotsubo syndrome is an acute cardiac syndrome characterized by transient systolic dysfunction of the left ventricle without coronary artery disease. It's etiology has not been fully explained, physical and intense emotional stress triggers this syndrome so it is also called "broken heart syndrome" or "stress cardiomyopathy". Takotsubu syndrome has been reported that approximately 2% of patients presenting with acute coronary syndrome. In this case, we presented a 65-year-old patient who had a Takotsubo syndrome attack after emotional stress, thinking that it would contribute to the literature and increase awareness of this disease.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Takotsubo syndrome triggered by emotional stress: a case report

Mulayim

2022

The European Research Journal

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“…It appears from current events like sudden emotional stressors and is known to result in acute heart failure or MI [ 80 ]. Anxiety disorders were also found to be significantly more frequent in Takotsubo patients than in patients with an acute coronary syndrome, this association is linked through inflammation leading to sympathetic activity [ 81 ]. The long-term mortality consequences are comparable to patients with acute coronary syndrome [ 82 ] which underlines the importance to consider mental stress and anxiety in CVD.…”

Section: Discussionmentioning

confidence: 99%

Structural Equation Modeling of a Global Stress Index in Healthy Soldiers

Maier¹,

Kugelmann²,

Rhee³

et al. 2021

JCM

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Accumulation of stress is a prognostic trigger for cardiovascular disease. Classical scores for cardiovascular risk estimation typically do not consider psychosocial stress. The aim of this study was to develop a global stress index (GSI) from healthy participants by combining individual measures of acute and chronic stress from childhood to adult life. One-hundred and ninety-two female and male soldiers completed the Perceived Stress Scale (PSS4), Trier Inventory for Chronic Stress (TICS), Hospital Anxiety and Depression Scale (HADS), Childhood Trauma Questionnaire (CTQ), Posttraumatic Diagnostic Scale Checklist (PDS), and the Deployment Risk and Resilience Inventory (DRRI-2). The underlying structure for the GSI was examined through structural equation modeling. The final hierarchical multilevel model revealed fair fit by taking modification indices into account. The highest order had a g-factor called the GSI. On a second level the latent variables stress, HADS and CTQ were directly loading on the GSI. A third level with the six CTQ subscales was implemented. On the lowest hierarchical level all manifest variables and the DRRI-2/PDS sum scores were located. The presented GSI serves as a valuable and individual stress profile for soldiers and could potentially complement classical cardiovascular risk factors.

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“…The discrepancy in findings between the current study and some prior studies may, in part, be explained by differences in sample size and study designs. Patients with TTS often have recurrent events, with the risk of reoccurrence being higher among patients with pre-admission psychiatric disorders[ 22 ]. With about 39% of patients with TTS reporting a neurological disease and 50% of patients with TTS reporting at least one mental disorder about 17.5 mo from their index event[ 23 ], future studies are warranted to investigate the potential role of therapeutics in preventing the incidence or reoccurrence of TTS in patients with neurologic and psychiatric disorders.…”

Section: Discussionmentioning

confidence: 99%

Association of marital status with takotsubo syndrome (broken heart syndrome) among adults in the United States

Appiah¹,

Farias²,

Helo³

et al. 2021

WJC

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BACKGROUND The pathophysiology of takotsubo syndrome (TTS) is not well understood, however, it is often precipitated by psychological or physical stress. Marital status is related to emotional stress, but its associations with TTS are limited. AIM To explored the potential association between marital status and TTS. METHODS We conducted a case-control study using data on patients aged ≥ 40 years with marital status data in the National Hospital Discharge Survey (2006-2010). The International Classification of Diseases Ninth Revision codes were used to identify cases with TTS and other comorbid conditions. Each case was matched to 5 controls by age, sex, year of TTS diagnosis and bed size of hospital. Two sets of controls were selected: Acute myocardial infarction (AMI) controls and non-cardiovascular disease (CVD) controls. Conditional logistic regression was used to estimate odds ratios (OR) and 95% confidence intervals (CI) for the association of marital status with TTS. RESULTS The 59 patients with TTS who had information on marital status were matched to 295 controls with AMI and 295 non-CVD controls, resulting in a sample of 649 patients. The average age of cases was 69.7 ± 11 years with 90% being women and 88% reporting White race. In multivariable-adjusted models, compared to singles, patients who were married had lower odds of TTS (OR = 0.86, 95%CI: 0.79–0.93) while those who were widowed (OR = 1.14, 95%CI: 1.05–1.23) or divorced/separated (OR = 1.32, 95%CI: 1.21–1.45) had elevated odds for TTS when compared to non-CVD controls. Similar results were observed when cases were compared to controls with AMI. CONCLUSION In this study, being married was associated with lower odds for TTS while being divorced/separated or widowed was related to elevated odds for TTS. These novel findings that underscore the potential importance of social factors like marital status in the development of TTS need confirmation in larger studies.

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Role of Depression and Anxiety Disorders in Takotsubo Syndrome: The Psychiatric Side of Broken Heart

Cited by 14 publications

References 50 publications

Takotsubo syndrome triggered by emotional stress: a case report

Takotsubo syndrome triggered by emotional stress: a case report

Structural Equation Modeling of a Global Stress Index in Healthy Soldiers

Association of marital status with takotsubo syndrome (broken heart syndrome) among adults in the United States

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