Motivation:

To identify drugs of abuse, chemical substances or animal poisons associated to

takotsubo cardiomyopathy.

Methods:

Structured review of Pubmed/Medline, where the following search terms were used:

Takotsubo cardiomyopathy, Tako-tsubo cardiomyopathy, stress cardiomyopathy, transient-leftventricular ballooning syndrome, ampulla cardiomyopathy, apical ballooning syndrome, OR broken heart syndrome; together with ''drugs abuse'', ''chemistry substance.'' ''iatrogenic'', ''drug-induced'' OR ''induced by''. Articles in English, French or Spanish published between January 1st 1990 and October 31st 2015 and with access to the full text were selected. Articles reporting drugs of abuse, chemical substances or animal poisons as possible triggers of this cardiomyopathy were included. Additionally, references of those selected articles were included, valued as relevant.

Results:

852 different articles were found, 23 were selected as well as 4 relevant references, where 38 takotsubo cardiomyopathy were identified, possibly associated to the use or exposure to drugs of abuse, chemical substances or animal poisons, especially carbon monoxide (n = 13; 34.2%), cocaine or crack (n = 5, 13.2%), alcohol withdrawal (n = 5; 13.2%), animal poison (n = 5; 13.2%) and amphetamines (n = 4; 10.5%). Overall 14 different substances were identified as possible triggers of this cardiomyopathy.

Conclusion:

Takotsubo cardiomyopathy could be triggered by the use or exposure to 14 drugs of abuse, chemical substances or animal poisons, which in most cases generate a sympathetic overstimulation. Thus it is recommended to consider this type of situation in patients presenting this kind of cardiomyopathy, especially in those where a physical or emotional trigger cannot be identified.

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