Opioid Intoxication to Withdrawal: A Case of Takotsubo Cardiomyopathy

TL;DR

An elderly woman with opioid dependence developed a heart condition called Takotsubo cardiomyopathy after opioid withdrawal, highlighting the risks of sudden opioid discontinuation.

Contribution

This case highlights opioid withdrawal as a rare but important cause of Takotsubo cardiomyopathy in opioid-dependent patients.

Findings

The patient developed Takotsubo cardiomyopathy following opioid withdrawal.

Symptoms improved with clonidine treatment.

The case emphasizes the need to monitor for TTC during opioid discontinuation.

Abstract

Takotsubo cardiomyopathy (TTC) is characterized by a transient reduction in left ventricular systolic function with apical akinesis. TTC is usually associated with stress and emotional responses; however, opioid withdrawal has been identified as a rare cause of precipitation of TTC. We describe the case of an elderly female with chronic opioid dependence, who presented with symptoms of toxicity and developed TTC upon opioid withdrawal. Her symptoms improved with clonidine. In the time of an ongoing opioid crisis and an attempt to reduce opioid use among patients, this case reinforces the importance of anticipating TTC as a possibly life-threatening complication of sudden discontinuation of opioids in patients who have developed dependence on it.

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