Takotsubo Cardiomyopathy After ECT: Case Report. Should it be Retracted?

Out on PubMed, from clinicians in Japan, is this case report:

A woman with schizophrenia who died due to Takotsubo cardiomyopathy occurring after electroconvulsive therapy.

Muto T, Kyono H.BMC Psychiatry. 2024 Feb 19;24(1):139. doi: 10.1186/s12888-024-05593-7.PMID: 38373994

The abstract is copied below:

Background: Electroconvulsive therapy (ECT) is a safe treatment for treatment-resistant schizophrenia. However, it has some side effects, and Takotsubo cardiomyopathy is considered one of the minor complications. Several cases of patients developing Takotsubo cardiomyopathy during a course of ECT have been reported, but none have died. We present a case of post-ECT Takotsubo cardiomyopathy that became fatal.

Case presentation: We experienced a case of a 67-year-old woman who had delusions and catatonic symptoms due to schizophrenia but was resistant to several medications. Her symptoms improved by conducting ECT, but she had difficulty maintaining her improvement, which caused her to receive multiple courses of ECT. 3 weeks after her 6th course of ECT, the patient was diagnosed with Takotsubo cardiomyopathy and had a fatal outcome.

Conclusion: Our patient had numerous cases of aspiration pneumonia and malnutrition before ECT was performed, which might have made this case fatal. In conclusion, appropriate supplementation of nutrition and reduction of physical stressors are important to avoid death from Takotsubo cardiomyopathy caused by ECT. Prescribing clozapine was a solution in the present case, but there are some difficulties, such as the restriction against prescribing this drug in Japan.

Keywords: Case report; Electroconvulsive therapy; Schizophrenia; Takotsubo
The case report is here.
And from the text:






I'm sorry, but this case report is an irresponsible hot mess. The patient had multiple comorbidities, the diagnosis of Takotsubo cardiomyopathy was not fully confirmed, and she died three weeks after the last ECT, with poor medical care. To blame this on ECT, as suggested in the title and text, is quite a stretch.
I would appreciate additional opinions from blog readers, thanks.

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