Broken heart syndrome: Tako Tsubo cardiomyopathy associated with an overdose of the serotonin–norepinephrine reuptake inhibitor Venlafaxine
Received 10 February 2010; received in revised form 26 March 2010; accepted 29 March 2010. published online 10 May 2010.
Abstract
Objective
To describe a case of Tako Tsubo cardiomyopathy [TTC] in a patient after an overdose of the serotonin–norepinephrine reuptake inhibitor [SNRI] Venlafaxine.
Methods
We present a case study including clinical and laboratory data. Current relevant literature is reviewed and summarized in regard to Tako Tsubo syndrome and SNRI.
Results
A 43year-old woman was admitted with acute angina pectoris after accidentally taking an overdose on Venlafaxine in order to treat major depression. Because of the ECG-T-wave-inversions in the precordial leads, the slightly increased Troponin/Creatine kinase levels and the apical systolic dysfunction of the left ventricle in echocardiogram a cardiac catheterization was performed. Coronary artery disease could be excluded by coronary angiography. The followed laevocardiography and cardiac MRI scan showed apical akinesis and basal hypercontractibility typical for apical ballooning (Tako Tsubo cardiomyopathy). Urine analysis revealed elevated normetanephrine level potentially caused by Venlafaxine. Six weeks after the first admission the echocardiogram showed a complete recovery to normal left ventricular function.
Conclusions
To our knowledge this is the first reported case of an overdose of Venlafaxine (SNRI) associated Tako Tsubo cardiomyopathy.
University of Technology Dresden, Department of Cardiology, Heart Center, University Hospital, Dresden, Germany
Corresponding author. University of Technology Dresden, Department of Cardiology, Heart Center, University Hospital, Dresden, Germany, Fetscherstrasse 76, 01307 Dresden, Germany. Tel.: +49 351 4500; fax: +49 351 4501701.
ABSTRACT