[OA] [Not the Onion] Trump Cardiomyopathy: A New Form of Takotsubo Cardiomyopathy
An 84-year-old man developed angina while watching televised coverage of the President Trump impeachment hearings and presented to the emergency department with positive cardiac biomarkers and EKG changes indicative of ST-elevation myocardial infarction.
Echocardiogram and coronary angiography were consistent with non-ischemic, 3 vessel coronary artery disease with apical hypokinesis resulting in the diagnosis of Takotsubo Cardiomyopathy.
This case is the first report of politically-induced cardiomyopathy and warrants further evaluation of political stress as an etiology of cardiac events.
Takotsubo cardiomyopathy is a stress-induced apical ballooning of the left ventricle in the absence of angiographically significant coronary artery stenosis. It can mimic the symptoms and biomarker profile of myocardial infarction.
Triggering events, such as loss of a loved one, psychological trauma and acute anxiety, can cause a catecholamine surge, possibly leading to coronary artery vasospasm and decreased oxygen delivery.
Although most cases resolve with medical management, serious complications, such as heart failure, cardiogenic shock, thromboembolism, and ventricular rupture can occur.
The etiologies of psychological distress that result in chest pain vary extensively. In the United States, a growing number of mental health specialists have identified a common source of stress: politics. Labeled "Trump Anxiety Disorder," psychiatrists have described a phenomenon of fear and anxiety related to current domestic politics.
In this report, we describe a patient who became emotionally distraught due to political events and, in turn, developed stress-induced cardiomyopathy.
Geisen WR, Rosse C, Menon S, Rudick S. Trump Cardiomyopathy: A New Form of Takotsubo Cardiomyopathy. Journal of Cardiac Failure. https://www.onlinejcf.com/article/S1071-9164(20)30139-1/fulltext