{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T11:22:39Z","timestamp":1785410559329,"version":"3.56.0"},"reference-count":11,"publisher":"Department of Medicine, Warren Alpert Medical School at Brown University","issue":"3","license":[{"start":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T00:00:00Z","timestamp":1782864000000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"abstract":"<jats:p>Takotsubo cardiomyopathy (TCM) is a transient stress-induced cardiomyopathy characterized by acute left ventricular systolic dysfunction in the absence of obstructive coronary artery disease. Electroconvulsive therapy (ECT) is known to provoke acute autonomic fluctuations and catecholamine surges, which may rarely precipitate TCM. We presented a middle-aged woman with coronary artery disease (CAD), bipolar disorder, and remote tobacco use who developed acute substernal chest pain radiating to the left arm approximately four hours after her first outpatient ECT session. Transthoracic echocardiography demonstrated a left ventricular ejection fraction (LVEF) of 36% with akinesis of the mid-to-distal apical segments, consistent with TCM. She was managed supportively and discharged with close follow-up by cardiology and psychiatry. ECT-induced Takotsubo cardiomyopathy is an uncommon but clinically significant complication mediated by excess catecholamine release. Recognition is essential, particularly in postmenopausal women with cardiovascular risk factors. Development of TCM does not represent an absolute contraindication to future ECT but warrants multidisciplinary evaluation and cardiovascular optimization prior to resumption.<\/jats:p>","DOI":"10.56305\/001c.162048","type":"journal-article","created":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T12:45:19Z","timestamp":1782909919000},"source":"Crossref","is-referenced-by-count":0,"title":["Electroconvulsive Therapy as a Trigger for Takotsubo Cardiomyopathy"],"prefix":"10.56305","volume":"5","author":[{"given":"My Anh","family":"Nguyen","sequence":"first","affiliation":[{"name":"Brown University, Warren Alpert Medical School","department":["Department of Medicine"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gabrielle","family":"Montalbano","sequence":"additional","affiliation":[{"name":"Brown University, Warren Alpert Medical School","department":["Department of Medicine"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pinar","family":"Arikan","sequence":"additional","affiliation":[{"name":"Brown University, Warren Alpert Medical School","department":["Department of Medicine"]},{"id":[{"id":"https:\/\/ror.org\/053exzj86","id-type":"ROR","asserted-by":"publisher"}],"name":"Miriam Hospital","department":["Division of Hospital Medicine"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"35509","published-online":{"date-parts":[[2026,7,1]]},"reference":[{"issue":"2","key":"ref1","first-page":"80","article-title":"Cardiovascular complications of ECT and strategies to reduce risk","volume":"28","author":"N. A. Youssef","year":"2012","journal-title":"J ECT"},{"issue":"3","key":"ref2","doi-asserted-by":"publisher","first-page":"185","DOI":"10.1097\/YCT.0000000000000905","article-title":"The safety and strategies for reinitiating electroconvulsive therapy after ECT-induced Takotsubo cardiomyopathy: a case report and systematic review","volume":"39","author":"M. Kinoshita","year":"2023","journal-title":"J ECT"},{"issue":"3","key":"ref3","first-page":"433","article-title":"Cardiovascular effects of electroconvulsive therapy","volume":"29","author":"Y. Kadoi","year":"2015","journal-title":"J Anesth"},{"issue":"15","key":"ref4","first-page":"1202","article-title":"Current state of knowledge on Takotsubo syndrome: a position statement from the Taskforce on Takotsubo Syndrome of the European Society of Cardiology","volume":"37","author":"A. R. Lyon","year":"2016","journal-title":"Eur Heart J"},{"issue":"10","key":"ref5","doi-asserted-by":"publisher","first-page":"929","DOI":"10.1056\/NEJMoa1406761","article-title":"Clinical features and outcomes of Takotsubo (stress) cardiomyopathy","volume":"373","author":"C. Templin","year":"2015","journal-title":"N Engl J Med"},{"issue":"6","key":"ref6","doi-asserted-by":"publisher","first-page":"19f13175","DOI":"10.4088\/JCP.19f13175","article-title":"Cardiovascular adverse effects of electroconvulsive therapy","volume":"80","author":"C. Andrade","year":"2019","journal-title":"J Clin Psychiatry"},{"issue":"8","key":"ref7","doi-asserted-by":"publisher","first-page":"1420","DOI":"10.1016\/j.amjcard.2014.01.419","article-title":"Meta-analysis of clinical correlates of acute mortality in Takotsubo cardiomyopathy","volume":"113","author":"K. Singh","year":"2014","journal-title":"Am J Cardiol"},{"issue":"6","key":"ref8","doi-asserted-by":"publisher","first-page":"307","DOI":"10.3325\/cmj.2018.59.307","article-title":"Takotsubo cardiomyopathy after the first electroconvulsive therapy regardless of adjuvant beta-blocker use: a case report and literature review","volume":"59","author":"S. Medved","year":"2018","journal-title":"Croat Med J"},{"key":"ref9","doi-asserted-by":"publisher","first-page":"8140289","DOI":"10.1155\/cric\/8140289","article-title":"Unexpected heartbreak: a case report of Takotsubo cardiomyopathy triggered by electroconvulsive therapy","volume":"2025","author":"F. Hosseini","year":"2025","journal-title":"Case Rep Cardiol"},{"issue":"6","key":"ref10","first-page":"676","article-title":"Takotsubo cardiomyopathy associated with electroconvulsive therapy: a case report and review of the literature","volume":"55","author":"S. R. Beach","year":"2014","journal-title":"Psychosomatics"},{"issue":"4","key":"ref11","doi-asserted-by":"publisher","first-page":"450.e1","DOI":"10.1136\/bcr-2014-206816","article-title":"Takotsubo cardiomyopathy following electroconvulsive therapy: case report and review","volume":"36","author":"A. Narayanan","year":"2014","journal-title":"Gen Hosp Psychiatry"}],"container-title":["Journal of Brown Hospital Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/bhm.scholasticahq.com\/article\/162048-electroconvulsive-therapy-as-a-trigger-for-takotsubo-cardiomyopathy","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T12:45:21Z","timestamp":1782909921000},"score":1,"resource":{"primary":{"URL":"https:\/\/bhm.scholasticahq.com\/article\/162048-electroconvulsive-therapy-as-a-trigger-for-takotsubo-cardiomyopathy"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7,1]]},"references-count":11,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2026]]}},"URL":"https:\/\/doi.org\/10.56305\/001c.162048","relation":{},"ISSN":["2994-5593"],"issn-type":[{"value":"2994-5593","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7,1]]}}}