Background: Anxiety disorders are more common in Takotsubo syndrome (TS) than in acute coronary syndrome patients. The aim of this study was to investigate whether pre-existing anxiety disorders predispose to TS triggered by exclusively emotional stressful events. Methods: Triggering events were compared in 58 TS patients with and without pre-existing anxiety disorders; clinical, electrocardiographic and echocardiographic data were also collected. Results: Thirty-one (53%) patients had a previous history of anxiety disorders. The exclusively emotional stressful event-rate was higher in TS patients with pre-existing anxiety disorder (74% vs. 30%, p = 0.001), while TS caused by an undetermined trigger were significantly higher in patients without anxiety disorders (33% vs. 10%, p = 0.027). Moreover, in TS patients without a previous history of anxiety disorders, a trend of higher prevalence of physical events was found (16% vs. 37%, p = 0.07). Conclusions: In patients with pre-existing anxiety disorders, TS was predominantly triggered by exclusively emotional stressful events, thereby suggesting a possible relationship between anxiety and emotional cardiac frailty in TS patients.
Anxiety disorders and stressful events in Takotsubo syndrome / Lazzeroni, Davide; Bini, Matteo; Castiglioni, Paolo; Moderato, Luca; Ciracì, Chiara; Camaiora, Umberto; Ugolotti, Pietro Tito; Brambilla, Lorenzo; Brambilla, Valerio; Garibaldi, Silvia; Paglialonga, Letizia; Ziveri, Valentina; Ugo, Fabrizio; Gaibazzi, Nicola; Coruzzi, Paolo. - In: CARDIOLOGY JOURNAL. - ISSN 1897-5593. - 25:4(2018), pp. 495-500. [10.5603/CJ.a2017.0136]