Abstract
Patients who attempt intentional suicide suffer from physical or emotional stress. This situation might be an important factor that causes takotsubo cardiomyopathy. We retrospectively investigated the clinical features of Takotsubo cardiomyopathy in patients with acute poisoning. This study included patients who were admitted from January 2010 to December 2015 because of intentional poisoning by ingestion. Among these patients, we selectively collected data of patients who underwent an echocardiogram. We divided the patients into three groups according to the echocardiogram; the non-cardiomyopathy group, the global hypokinesia group, and the takotsubo cardiomyopathy group. One hundred forty-seven patients were analyzed in this study. One hundred thirty-one patients had normal cardiac function without regional wall motion abnormality. Global hypokinesia was observed in five patients. The overall incidence of takotsubo cardiomyopathy was 7.5% (11/147). Levels of cardiac enzymes including CK-MB, Troponin T, a marker of cardiac muscle ischemia, were higher in the global hypokinesia group and the takotsubo cardiomyopathy group compared with the non-cardiomyopathy group. The most commonly consumed poison was organophosphate in the takotsubo cardiomyopathy group. In conclusion, takotsubo cardiomyopathy may be one of the cardiac complications in patients who attempt suicide by consuming a poison.
Highlights
In 2014, 2,165,142 human exposures were reported in USA1
We divided the patients into three groups according to the echocardiogram; the non-cardiomyopathy group, the global hypokinesia group, and the takotsubo cardiomyopathy group
Our study suggested that the incidence of takotsubo cardiomyopathy was approximately 7.4% among patients with acute poisoning who had undergone echocardiography
Summary
In 2014, 2,165,142 human exposures were reported in USA1. The mortality rate was less than 5%, but the mortality rate or complications could be different according to the poison[2,3]. Systemic symptoms are different according to the poison, cardiovascular complication is important in acute poisoning. Some reports have shown that takotsubo cardiomyopathy, known as transient left ventricular ballooning syndrome or stress cardiomyopathy, could be one of the causes of cardiac complication in patients with acute poisoning[4,5,6,7]. Acute physical or emotional distress is thought to play a role in the development of stress cardiomyopathy through spike-like sympathetic stimulation[9]. Patients who attempt intentional suicide suffer from physical or emotional stress. This situation might be an important factor that causes takotsubo cardiomyopathy. We retrospectively investigated the clinical features of Takotsubo cardiomyopathy in patients with acute poisoning
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