Abstracts

Rationale: Takotsubo syndrome (TTS) is a form of acute systolic cardiomyopathy and is frequently a reversible condition. It often presents similarly to an acute coronary syndrome but occurs in the absence of epicardial obstructive coronary artery disease. TTS more commonly affects postmenopausal women after a stressful event, either physiological or psychological. It is believed to be caused by an acute release of catecholamines, underlying microvascular dysfunction, and possibly coronary artery spasm. Neurological disorders have been described as important triggering factors of TTS. Conditions such as ischemic and hemorrhagic strokes, subarachnoid hemorrhages, and seizures (including status epilepticus) are examples of neurological conditions previously associated with a higher risk for TTS. Neurological disorders can result in brain alterations in the limbic system, functional changes in the central autonomic network, and neurochemical derangements which may lead to an impaired communication between the brain and heart. An increase in the sympathetic outflow to the heart and potentially cardiotoxic circulating norepinephrine levels are additional possible contributors in the development of TTS. Since TTS is becoming an increasingly recognized condition in the neurological wards and neurointensive care units, we sought to assess the impact of seizure disorder in TTS patients’ clinical presentation as well as inpatient morbidity and mortality.

Methods: We conducted a retrospective descriptive study reviewing patients with the discharge diagnosis of TTS and seizure disorder between 2003-2021 at Baptist Medical Center, Jacksonville, Florida. Study subjects were screened using 2021 ICD-10-CM codes. A total of 448 subjects met the Modified Mayo Clinic criteria and were included in the study. Baseline demographic characteristics, past medical history, imaging data, and in-hospital mortality were collected after the study's approval by the hospital's Institutional Review Board (IRB). Chi-squared and Student t-tests were used to assess statistical differences in categorical and continuous variables, respectively. A two-tailed P < 0.05 was considered statistically significant.