Takotsubo cardiomyopathy (TC) is an acute cardiac dysfunction, clinically similar to myocardial ischemia. The physiopathology of the syndrome seems to be related to excessive sympathetic activity that is triggered by physical or emotional stress factors. We report the case of an 83-year-old woman with advanced Alzheimer disease who had recently used nortriptyline and sertraline and was admitted with chest pain. An electrocardiogram showed ST-elevation, and markers of myocardial necrosis were slightly increased. However, coronariography did not demonstrate stenotic lesions. Transthoracic echocardiography and ventriculography identified decreased ventricular function, apical akinesia, and compensatory hyperkinesia of other segments that were compatible with TC. The patient evolved with cardiogenic shock and died. Alzheimer patients may be more susceptible to develop TC, both because of the disease itself and because of the multiple medications they are exposed to that increase catecholamine levels. In this case, antidepressant drugs were considered to be a potential factor that enhanced the susceptibility.

中文翻译：

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阿尔茨海默病患者的 Takotsubo 心肌病：抗抑郁药的潜在贡献。

Takotsubo 心肌病 (TC) 是一种急性心脏功能障碍，临床上与心肌缺血相似。该综合征的病理生理学似乎与由身体或情绪压力因素引发的过度交感神经活动有关。我们报告了一名患有晚期阿尔茨海默病的 83 岁女性的病例，她最近使用了去甲替林和舍曲林，因胸痛入院。心电图显示ST段抬高，心肌坏死标志物轻度升高。然而，冠状动脉造影未显示狭窄病变。经胸超声心动图和心室造影确定了与 TC 相容的其他节段的心室功能下降、心尖运动不能和代偿性运动过度。患者发展为心源性休克并死亡。阿尔茨海默病患者可能更容易患上 TC，这既是因为疾病本身，也是因为他们接触的多种药物会增加儿茶酚胺水平。在这种情况下，抗抑郁药被认为是增强易感性的潜在因素。