RESUMO
Takotsubo cardiomyopathy is a syndrome characterized by transient apical ballooning or reversible midventricular systolic dysfunction. Most cases occur in postmenopausal women and are typically triggered by an acute medical illness or emotional or physical stress. Its presentation is highly suggestive of myocardial ischemia, but there is little or no evidence of epicardial coronary artery disease. To our knowledge there are only three reported cases in the literature of Takotsubo cardiomyopathy induced by opioid agonist withdrawal in adults; ours is the first reported case of iatrogenic methadone withdrawal leading to Takotsubo cardiomyopathy.
Assuntos
Analgésicos Opioides/intoxicação , Doença Iatrogênica , Metadona/intoxicação , Naloxona/efeitos adversos , Antagonistas de Entorpecentes/efeitos adversos , Tratamento de Substituição de Opiáceos , Transtornos Relacionados ao Uso de Opioides/reabilitação , Cardiomiopatia de Takotsubo/etiologia , Analgésicos Opioides/administração & dosagem , Angiografia Coronária , Overdose de Drogas , Ecocardiografia , Eletrocardiografia , Humanos , Masculino , Metadona/administração & dosagem , Pessoa de Meia-Idade , Naloxona/administração & dosagem , Antagonistas de Entorpecentes/administração & dosagem , Cardiomiopatia de Takotsubo/diagnóstico , Cardiomiopatia de Takotsubo/terapiaRESUMO
Lately, there has been an increased incidence of late stent thrombosis; especially following Drug eluting stent (DES) implantation. Several factors are associated with an increased risk of stent thrombosis, including the procedure itself, patient and lesion characteristics, stent design, and premature cessation of anti-platelet drugs. We present a case of late stent thrombosis (LST) following DES implantation after a period of 68 months, making it the longest reported case of LST reported in the literature, despite the use of dual anti-platelet therapy.