Increased ocurrence of Takotsubo syndrome during COVID-19 lockdown

Funding Acknowledgements Type of funding sources: None. Background severe and numerous restrictions were taken in Spain during lockdown. Significant consequences from the physical and emotional point of view were described. Pathophysiology of Takotsubo syndrome (TKS) is complex but the ocurrence of acute emotional or physical triggers is found in almost 50% of cases. Methods and purpose Retrospective study to compare patients treated by urgent coronary angiography during the period of lockdown in Spain (03/15/2020 to 05/31/2020) and patients in the same period of the previous year (2019). The aim is to present our experience comparing the two periods and to evaluate the incidence of TKS during lockdown. Results We included 73 patients from the pre-COVID period (2019) and 67 patients from the lockdown period. We found 4 cases of TKS during lockdown (6%) versus 0 cases in pre-COVID period. Baseline characteristics are shown in table 1. All cases of TKS were female. The median age was 66 years +/- 12. In 2 cases there was an emotional trigger (stress or anxiety) but in the other 2 cases the trigger was unknown. All patients with TKS presented left ventricular systolic dysfunction. Three cases showed typical wall motion abnormalities (apical and mid wall segments) and one case had circumferential hypokinesia of basal segments (consistent with reversed TKS). 3 cases were negative for COVID-19 PCR test and 1 unsuspected case was not tested for COVID-19. One patient with out-of-hospital cardiac arrest died while receiving mechanical ventilation. Conclusions In our centre, during COVID-19 lockdow, we observed an increase in incidence of TKS compared to the same period of the previous year. An emotional trigger was only found in half of the cases. Table 1Age yr /* Font Definitions */ @font-face {font-family:"Cambria Math"; panose-1:2 4 5 3 5 4 6 3 2 4; mso-font-charset:1; mso-generic-font-family:roman; mso-font-format:other; mso-font-pitch:variable; mso-font-signature:0 0 0 0 0 0;} @font-face {font-family:Calibri; panose-1:2 15 5 2 2 2 4 3 2 4; mso-font-charset:0; mso-generic-font-family:swiss; mso-font-pitch:variable; mso-font-signature:-469750017 -1073732485 9 0 511 0;} /* Style Definitions */ p.MsoNormal, li.MsoNormal, div.MsoNormal {mso-style-unhide:no; mso-style-qformat:yes; mso-style-parent:""; margin-top:0cm; margin-right:0cm; margin-bottom:8.0pt; margin-left:0cm; line-height:107%; mso-pagination:widow-orphan; font-size:11.0pt; font-family:"Calibri",sans-serif; mso-ascii-font-family:Calibri; mso-ascii-theme-font:minor-latin; mso-fareast-font-family:Calibri; mso-fareast-theme-font:minor-latin; mso-hansi-font-family:Calibri; mso-hansi-theme-font:minor-latin; mso-bidi-font-family:"Times New Roman"; mso-bidi-theme-font:minor-bidi; 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