Brief ReportsTakotsubo Cardiomyopathy in an Alzheimer Disease Patient The Potential Contribution of Antidepressant AgentsMoulin Mares, Stephanie R.A. PhD*,†; Groner, Jaqueline S. MD*; de Oliveira, Melissa P. MD*; Lírio, Ludmilla V. MD*; Coutinho, Paulo C. MD*; Luchi, Weverton M. PhD*Author Information *Hospital Universitário Cassiano Antônio de Moraes (HUCAM), Universidade Federal do Espírito Santo (UFES) †Department of Physiological Sciences, Federal University of Espírito Santo (UFES), Vitória, Espirito Santo, Brazil The authors declare no conflicts of interest. Reprints: Stephanie R.A. Moulin Mares, PhD, Hospital Universitário Cassiano Antônio de Moraes (HUCAM), Universidade Federal do Espirito Santo, Vitoria, Espirito Santo 29042-755, Brazil (e-mail: [email protected]) Alzheimer Disease & Associated Disorders: October–December 2020 - Volume 34 - Issue 4 - p 360-361 doi: 10.1097/WAD.0000000000000395 Buy Metrics Abstract Takotsubo cardiomyopathy (TC) is an acute cardiac dysfunction, clinically similar to myocardial ischemia. The physiopathology of the syndrome seems to be related to excessive sympathetic activity that is triggered by physical or emotional stress factors. We report the case of an 83-year-old woman with advanced Alzheimer disease who had recently used nortriptyline and sertraline and was admitted with chest pain. An electrocardiogram showed ST-elevation, and markers of myocardial necrosis were slightly increased. However, coronariography did not demonstrate stenotic lesions. Transthoracic echocardiography and ventriculography identified decreased ventricular function, apical akinesia, and compensatory hyperkinesia of other segments that were compatible with TC. The patient evolved with cardiogenic shock and died. Alzheimer patients may be more susceptible to develop TC, both because of the disease itself and because of the multiple medications they are exposed to that increase catecholamine levels. In this case, antidepressant drugs were considered to be a potential factor that enhanced the susceptibility. Copyright © 2020 Wolters Kluwer Health, Inc. All rights reserved.