Takotsubo cardiomyopathy may appear during withdrawal from a range of abused substances.
Substances reported to be associated with takotsubo cardiomyopathy during withdrawal include:
(1) alcohol
(2) benzodiazepine
(3) heroin, buprenorphine, or other opiates
Clinical features at presentation:
(1) tachycardia
(2) hypotension or hypertension
(3) dyspnea
(4) nausea and vomiting
(5) chest pain
(6) altered mental status
The serum troponin concentration may be elevated.
The diagnosis is typically made by echocardiography.
Diagnostic criteria:
(1) absence of takotsubo cardiomyopathy prior to withdrawal
(2) onset of a withdrawal reaction
(3) onset of the takotsubo cardiomyopathy after the onset of the withdrawal reaction
(4) no other explanation for the cardiomyopathy
(5) clinical improvement after recovery from the withdrawal reaction
