title: Vulnerable personality and Takotsubo cardiomyopathy consequent to emotional stressful events: a clinical case report.
abstract: BACKGROUND
  Although the onset of Takotsubo cardiomyopathy (TTC) can be triggered by an acute, intense emotional stress, the exact pathogenic mechanisms still remain undefined.
  
  
  METHODS
  A 58-year-old female was sent by ambulance to the Emergency Department (ED) for chest pain and ST elevations on ECG. Her chest pain began 3 hours before on admission after a domestic argument. Transthoracic echocardiogram showed severe systolic dysfunction with an ejection fraction of 20%. Cardiac catheterization revealed no significant coronary artery disease. The left ventriculogram showed apical ballooning with hyperdynamic proximal segments. A diagnosis of Takotsubo Cardiomyophaty (TTC) was made according to the Mayo Clinic 2008 criteria. The patient evolved with improvement of her condition and, therefore, was discharged from the hospital. Follow-up echocardiogram seven days later showed normal LV size and function with ejection fraction (EF) of 43%. Paykel Life Stress Event Scale identified as emotional trigger a domestic argument occurred 3 hours before symptom onset. History showed a major life stress event, death of a loved one, six months before symptoms. The patient underwent psychological assessment after hospital discharge by Emotional Regulation Questionnaire and BDI showing high suppression/ low reappraisal profile and moderate depression.
  
  
  CONCLUSIONS
  This case highlights the hypothesis of a possible link between cognitive emotional processing and vulnerability to Takotsubo syndrome.
authors: University of Bergamo, Italy. angelo.compare@unibg.it
authors: Angelo
authors: A
authors: Compare
authors: Riccardo
authors: R
authors: Proietti
authors: Domenico
authors: D
authors: Del Forno
authors: Alessandra
authors: A
authors: Vitelli
authors: Alessandra
authors: A
authors: Grieco
authors: Luigi
authors: L
authors: Maresca
authors: Francesco
authors: F
authors: Giallauria
mesh_terms: D006328:Cardiac Catheterization; D003863:Depression / Q000175:diagnosis / Q000523:psychology*; D003937:Diagnosis, Differential; D004452:Echocardiography; D004562:Electrocardiography; D005260:Female; D006801:Humans; D008875:Middle Aged; D011569:Psychiatric Status Rating Scales; D012307:Risk Factors; D013315:Stress, Psychological / Q000175:diagnosis / Q000523:psychology*; D054549:Takotsubo Cardiomyopathy / Q000175:diagnosis* / Q000523:psychology*