Recurrent Takotsubo Cardiomyopathy Due to Benzodiazepine Withdrawal.

BACKGROUND

Takotsubo cardiomyopathy (TCM) is a rare cause of acutely decompensated heart failure among patients without pre-existing chronic heart failure. We present a case of recurrent TCM attributed to benzodiazepine withdrawal.

CASE SUMMARY: A 40-year-old woman with prior TCM and reverse TCM was admitted for cardiogenic shock after having recently changed her benzodiazepine regimen. She was emergently cannulated for venoarterial extracorporeal membrane oxygenation; transthoracic echocardiography showed an ejection fraction of 10% to 15% with apical hypokinesis. Intra-aortic balloon pump was added as a bridge to decannulation. Her ejection fraction recovered to 60% on discharge.

DISCUSSION: Benzodiazepine withdrawal-induced TCM is sparsely reported in the literature, and to our knowledge, no reports of benzodiazepine withdrawal-induced TCM requiring extracorporeal membrane oxygenation have been documented.

TAKE-HOME MESSAGE: It is important to recognize the echocardiographic patterns of TCM, consider benzodiazepine withdrawal, and understand the role of mechanical cardiac support in TCM-induced cardiogenic shock.