Takotsubo cardiomyopathy in children

Abstract

Objective: To explore the epidemiology and outcomes of takotsubo cardiomyopathy in children. Methods: A retrospective analysis of the Healthcare Cost and Utilization 2012 and 2016 Kids’ Inpatient Database was performed. Patients admitted with the diagnosis of takotsubo cardiomyopathy in the age group of 1 month–20 years were identified using International Classification of Diseases (ICD)-9 code 429.83 and ICD-10 code I51.81. Results: Among a total of 4,860,859 discharges, there were 153 with the diagnosis of takotsubo cardiomyopathy (3.1 per 100,000 discharges). Among patients with takotsubo cardiomyopathy, 55.0% were male, 62.4% were white, and 16.7% were black. Eighty-nine percent of patients were between 12 and 20 years. Psychiatric diagnosis was documented in 46% and substance use disorder in 36.2%. Sepsis was documented in 22.8% of patients. The median length of stay was 5 days (interquartile range: 2.7–15), and median total charges were $75,080 (interquartile range: 32,176–198,336). The overall mortality for takotsubo cardiomyopathy was 7%. On multivariable regression analysis, mortality was higher in the presence of anoxic injury (odds ratio = 34.42, 95% confidence interval: 4.85–320.11, p = 0.00). Conclusions: Takotsubo cardiomyopathy is uncommon in children and carries a mortality rate of 7%. Most children with takotsubo cardiomyopathy are adolescent males, many of whom have psychiatric disorder or substance use disorder or both. Takotsubo cardiomyopathy should be considered in the differential diagnosis for patients who present with cardiac dysfunction and have underlying psychiatric disorders or drug abuse.

Takotsubo cardiomyopathy in a toddler with pulmonary atresia and ventricular septal defect

“…Although TC is often triggered by sepsis in severely ill adults, 5 insufficient information is available for children. 2 TC triggered by sepsis and septic cardiomyopathy partially overlap. 6 Therefore, future studies are warranted to determine the association of TC with CHD and sepsis in children.…”

“…1 It is rare in children, particularly young children. 2 Very few cases of TC development in children with congenital heart diseases (CHDs) have been reported. 3 4 To the best of our knowledge, the present case is the first report on TC development in a child with pulmonary atresia and ventricular septal defect.…”

Heartbroken Child: A Rare Case Report of Neurogenic Pulmonary Edema and Takotsubo Cardiomyopathy following Recurrent Medulloblastoma Excision with Possible Aetio-Patho-Bio-Physiological Mechanisms

“…It is mainly seen in women of older age secondary to emotional, physical, or psychological stress [1,4,5]. In age less than 18 years, it is mainly seen in adolescents suffering from psychiatric disorders and substance abuse [6,7]. In children, it is rarely described [6][7][8], even though extradural cerebellar haematoma [9], parenchymal cerebellar haematoma [9], and acute hydrocephalus [10,11] secondary to any cause have been described in single case reports.…”

“…In age less than 18 years, it is mainly seen in adolescents suffering from psychiatric disorders and substance abuse [6,7]. In children, it is rarely described [6][7][8], even though extradural cerebellar haematoma [9], parenchymal cerebellar haematoma [9], and acute hydrocephalus [10,11] secondary to any cause have been described in single case reports. We present here a very unique case of a 12-year-old child with neurogenic pulmonary oedema (NPE) and takotsubo cardiomyopathy (TCM) syndrome after surgery for recurrent medulloblastoma.…”

Catecholamine-Induced Secondary Takotsubo Syndrome in Children With Severe Enterovirus 71 Infection and Acute Heart Failure: A 20-year Experience of a Single Institute

“…The reported incidence of cardiogenic shock in TTS patients ranges from 6 to 20% ( 15 ). Takotsubo syndrome most commonly occurs in postmenopausal women ( 15 , 16 ), but is an uncommon condition in children ( 17 , 18 ). The pathogenesis of TTS remains largely uncertain.…”