Catecholamines, stress cardiomyopathy

Drug withdrawal Stress (takotsubo) cardiomyopathy occurred in a 44-year-old man in whom severe opioid withdrawal was precipitated 2 hours after administration of naltrexone for alcohol consumption [117 ]. He had a history of heroin use and was taking methadone 120mg/day. Stress cardiomyopathy was beheved to be the result of a marked increase in catecholamine plasma concentrations following abrupt opioid withdrawal. 

Tiong K. Irukandji syndrome, catecholamines, and mid-ventricular stress cardiomyopathy. Eur J Echocardiogr 2009 10 (2) 334-6. 

Abraham J, Mudd JO, Kapur N, Klein K, Champion HC, Wittstein IS. Stress cardiomyopathy after intravenous administration of catecholamines and beta-receptor agonists. J Am Coll Cardiol 2009 53(15) 1320-5. 

Mechanism In various observational studies of this type of cardiomyopathy there was an association with raised catecholamine concentrations [3", 4, 5 f There have ako been several reports following severe emotional stress /6,7 ], in patients with pheo-chromocytomas, both adrenal [8, Pa l(f, 11 ] and extra-adrenal [12, 13, 14 ], and in patients who have been given catecholamines [15 =, 16, 17, 18, 19, 20 f In five consecutive patients with takotsubo-like left ventricular dysfunction there was local release of noradrenaline from the heart as measured in blood taken from the aortic root and coronary sinus [21 ]. 

Boulmier D, Bazin P. Tableau de pseudo-infarctus du myocarde cardiomyopathie catecholergique aigue de stress ou spasme coronarien [Myocardial pseudoinfarction stress -associated catecholamine-induced acute cardiomyopathy or coronary spasm ] Ann Cardiol Angeiol (Paris) 2000 49(8) 449-54. 

Takizawa M, Kobayakawa N, Uozumi H, Yonemura S, Kodama T, Fukusima K, Takeuchi H, Kaneko Y, Kaneko T, Fujita K, Honma Y, Aoyagi T. A case of transient left ventricular ballooning with pheochromocytoma, supporting pathogenetic role of catecholamines in stress-induced cardiomyopathy or takotsubo cardiomyopathy. Int J Cardiol 2007 114(1) el5-7. 

Lyon AR, Rees PS, Prasad S, Poole-Wilson PA, Harding SE. Stress (Takotsubo) cardiomyopathy—a novel pathophysiological hypothesis to explain catecholamine-induced acute myocardial stunning. Nat Clin Pract Cardiovasc Med 2008 5(1) 22-9. 

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