Epilepsy and Takotsubo cardiomyopathy: a scope review

Abstract

Introduction. The incidence of sudden death is high in people with chronic epilepsy, especially in the presence of cardiovascular comorbidities, thus, there is a convergence between epilepsy and cardiovascular diseases, however the literature fails on systematic reviews analyzing the interface between epilepsy and Takotsubo cardiomyopathy. Objective. To verify the association between Takotsubo cardiomyopathy and neurological disorders, especially epilepsy. Method. This is a scope review, based on the PRISMA checklist. An advanced and high-sensitivity search was performed using the descriptors "epilepsy" and "Takotsubo cardiomyopathy" combined with the Boolean operator AND, in PubMED, Scientific Electronic Library Online, Portal Regional Biblioteca in Health, and CAPES Periodicals. Results. A total of 373 articles were identified and after applying the eligibility criteria, 14 works were selected to compose the bibliographic sample of this study. It demonstrates the relationship of people with epilepsy developing Takotsubo cardiomyopathy, especially women with advanced age, with comorbidities such as arterial hypertension, diabetes mellitus and hypercholesterolemia, and changes could be evidenced through electrocardiogram and transthoracic echocardiogram. Conclusion. ST-segment depression in the anterior wall and T-wave inversion on the electrocardiogram may suggest Takotsubo cardiomyopathy in people with epilepsy, and this monitoring is important because of the potential for seizures to lead to cardiac conditions. Transthoracic echocardiography is useful for identifying adverse events in people with the comorbidity. Knowledge about epidemiology and the complementary findings described can facilitate clinical reasoning for the diagnosis and management of the condition.