THE IMPACT OF MENTAL DISORDERS AND PSYCHIATRIC TREATMENT ON THE OCCURRENCE AND COURSE OF TAKOTSUBO SYNDROME - REVIEW

Abstract

The aim of this review was to summarize existing knowledge on pathophysiology and analyze the influence of mental health disorders and psychiatric treatment on the occurrence and course of Takotsubo syndrome (TTS). This review paper was based on resources available in the PubMed database; articles were identified using the following keywords: [takotsubo] + [SNRI; SSRI; ECT; psychotherapy; anxiolytics; neuroleptics]. Additionally, a manual search of the literature cited in the articles was conducted. In order that we could treat TTS properly, we need to know its pathophysiology. The current approach regards a combination of various pathophysiological mechanisms rather than one mechanism alone. Although firstly considered as “stress” or “catecholamine”, Takotsubo cardiomyopathy is more than a simple reaction to stress or catecholamine surge. Novel data indicate a complex interplay between endothelial dysfunction, inflammatory, hormones and neurotransmitters. That leads us to the conclusion that we should treat it interdisciplinary. As there are currently no specific treatments for Takotsubo syndrome, a niche for neurocardiology is emerging. This could lead to developing new management approaches, including broader application of cognitive behavioral therapy and cooperation between cardiologists and psychiatrists.