Takotsubo cardiomyopathy after anti-influenza vaccination: catecholaminergic effects of immune system. (Petrillo)

Am J Emerg Med. 2013 Jul 25. PMID: 23891597

“Takotsubo cardiomyopathy (TTC) is a well-known condition, which leads to sudden transient regional systolic dysfunction. It mostly affects aging women and is usually precipitated by emotional or physical stress. Despite the tremendous amount of literature on TTC, cardiac sympathetic hyperactivity is the only thing known to be associated with pathogenesis. In our case, an elderly woman presented with an acute episode of TTC 24 hours after anti-influenza vaccination without any obvious stressor for sudden rise in the catecholamine level. Sudden postvaccination change in the cardiac sympathetic discharge is the most likely precipitant of TTC in this case.

Takotsubo cardiomyopathy (TTC), also known as stress cardiomyopathy, was first described in Japan in 1991 [1]. Takotsubo cardiomyopathy can be defined based on transient left ventricular (LV) systolic dysfunction that presents as an acute coronary syndrome in the absence of any significant coronary artery disease. Takotsubo cardiomyopathy predominantly affects aging women and is usually preceded by an emotional or physical stress [2]. It is postulated that catecholamine-mediated myocardial stunning induces TTC [3]. However, why an increase in catecholamines affects some individuals and not others, why mostly women, and why the LV apex is predominantly affected are some of the many questions that are currently unanswered.”

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