Buprenorphine withdrawal induced takotsubo cardiomyopathy: A series of unfortunate events

Ageliki Laina; Georgios Latsios; Eirini Dri; Constantina Aggeli; Eleftherios Tsiamis; Kostas Tsioufis

doi:10.1016/j.jccase.2021.11.012

Buprenorphine withdrawal induced takotsubo cardiomyopathy: A series of unfortunate events

J Cardiol Cases. 2022 Jan 4;25(5):316-318. doi: 10.1016/j.jccase.2021.11.012. eCollection 2022 May.

Authors

Ageliki Laina¹, Georgios Latsios¹, Eirini Dri¹, Constantina Aggeli¹, Eleftherios Tsiamis¹, Kostas Tsioufis¹

Affiliation

¹ 1st Department of Cardiology, National and Kapodistrian University of Athens, "Hippocratio" General Hospital, Athens, Greece.

Abstract

This case report describes a 64-year-old female with history of previous intravenous drug abuse on opioid substitution treatment with buprenorphine, who presented to the emergency department with angina and electrocardiographic findings suggestive of acute coronary syndrome. Echocardiography and left ventriculography were indicative of takotsubo cardiomyopathy, probably attributed to abrupt discontinuation of buprenorphine. Opioid withdrawal leads to sympathetic hyperactivity and increased catecholamine release, which in our case triggered takotsubo cardiomyopathy presentation. <Learning objective: Buprenorphine withdrawal may precipitate takotsubo cardiomyopathy.>.

Keywords: Buprenorphine; Heart failure; Opioid withdrawal; Stress cardiomyopathy; Takotsubo.

Publication types

Case Reports