# Unexpected Heartbreak: A Case Report of Takotsubo Cardiomyopathy Triggered by Electroconvulsive Therapy

## TL;DR

An elderly woman developed Takotsubo cardiomyopathy after electroconvulsive therapy, highlighting a rare but serious risk.

## Contribution

This case report highlights the previously under-recognized risk of Takotsubo cardiomyopathy following ECT.

## Key findings

- A 73-year-old woman developed chest pain, ECG changes, and reduced ejection fraction after ECT.
- Takotsubo cardiomyopathy was diagnosed with normal coronary arteries and elevated Troponin I.
- The patient recovered with medical treatment, showing improved ejection fraction within days.

## Abstract

A 73-year-old woman who suffered from major depressive disorder was candidated to receive electroconvulsive therapy (ECT) in combination with medical treatment. Shortly after ECT, she complained of severe chest pain. ECG findings revealed new QRS widening and ST-segment elevation in anterior leads, and echocardiography revealed anteroapical wall akinesia and reduced ejection fraction. Epicardial coronary arteries were normal in emergent coronary angiography, and the diagnosis of Takotsubo cardiomyopathy was considered. In addition, Troponin I was also elevated. The patient had a good recovery after medical treatment for heart failure, and the ejection fraction in echocardiography improved in a few days. This studied case demonstrates the increasing risk of Takotsubo cardiomyopathy following ECT, which needs special attention for patients with chest pain and ECG abnormalities after ECT.