| Prior to admission | The patient discontinued alprazolam 3 days prior to admission. |
| Day 0 (at home) | The patient presented altered mental status after generalized tonic–clonic seizure and received 10 mg of IV diazepam and 500 mg of levetiracetam. |
| Day 0 (emergency department) | Acute pulmonary oedema with a slightly elevated troponin I concentration (5407 ng/L) and B-type natriuretic peptide (1627.0 µg/L). |
| Transthoracic echocardiogram revealed a ballooning of the left ventricle apex with dyskinesia of the mid and apical segments (ejection fraction 15%). Coronary angiography showed no abnormalities. Left ventriculography showed severe left ventricular (LV) systolic dysfunction with akinesia of the mid and apical LV segments and hyperdynamic basal segments. | |
| A presumptive diagnosis of Takotsubo syndrome secondary to benzodiazepine withdrawal was made. | |
| Day 0 (intensive care unit) | Administration of diazepam 10 mg intravenous (three times daily). |
| Day 7 | Hospital discharge, with alprazolam (2 mg/day). Follow-up transthoracic echocardiogram showed improvement of LV function with complete resolution of the wall motion abnormalities. |
| 6-month follow-up | Asymptomatic with a normal biventricular function. Beta-blocker was successfully introduced as part of a lifelong plan. |
| Prior to admission | The patient discontinued alprazolam 3 days prior to admission. |
| Day 0 (at home) | The patient presented altered mental status after generalized tonic–clonic seizure and received 10 mg of IV diazepam and 500 mg of levetiracetam. |
| Day 0 (emergency department) | Acute pulmonary oedema with a slightly elevated troponin I concentration (5407 ng/L) and B-type natriuretic peptide (1627.0 µg/L). |
| Transthoracic echocardiogram revealed a ballooning of the left ventricle apex with dyskinesia of the mid and apical segments (ejection fraction 15%). Coronary angiography showed no abnormalities. Left ventriculography showed severe left ventricular (LV) systolic dysfunction with akinesia of the mid and apical LV segments and hyperdynamic basal segments. | |
| A presumptive diagnosis of Takotsubo syndrome secondary to benzodiazepine withdrawal was made. | |
| Day 0 (intensive care unit) | Administration of diazepam 10 mg intravenous (three times daily). |
| Day 7 | Hospital discharge, with alprazolam (2 mg/day). Follow-up transthoracic echocardiogram showed improvement of LV function with complete resolution of the wall motion abnormalities. |
| 6-month follow-up | Asymptomatic with a normal biventricular function. Beta-blocker was successfully introduced as part of a lifelong plan. |
| Prior to admission | The patient discontinued alprazolam 3 days prior to admission. |
| Day 0 (at home) | The patient presented altered mental status after generalized tonic–clonic seizure and received 10 mg of IV diazepam and 500 mg of levetiracetam. |
| Day 0 (emergency department) | Acute pulmonary oedema with a slightly elevated troponin I concentration (5407 ng/L) and B-type natriuretic peptide (1627.0 µg/L). |
| Transthoracic echocardiogram revealed a ballooning of the left ventricle apex with dyskinesia of the mid and apical segments (ejection fraction 15%). Coronary angiography showed no abnormalities. Left ventriculography showed severe left ventricular (LV) systolic dysfunction with akinesia of the mid and apical LV segments and hyperdynamic basal segments. | |
| A presumptive diagnosis of Takotsubo syndrome secondary to benzodiazepine withdrawal was made. | |
| Day 0 (intensive care unit) | Administration of diazepam 10 mg intravenous (three times daily). |
| Day 7 | Hospital discharge, with alprazolam (2 mg/day). Follow-up transthoracic echocardiogram showed improvement of LV function with complete resolution of the wall motion abnormalities. |
| 6-month follow-up | Asymptomatic with a normal biventricular function. Beta-blocker was successfully introduced as part of a lifelong plan. |
| Prior to admission | The patient discontinued alprazolam 3 days prior to admission. |
| Day 0 (at home) | The patient presented altered mental status after generalized tonic–clonic seizure and received 10 mg of IV diazepam and 500 mg of levetiracetam. |
| Day 0 (emergency department) | Acute pulmonary oedema with a slightly elevated troponin I concentration (5407 ng/L) and B-type natriuretic peptide (1627.0 µg/L). |
| Transthoracic echocardiogram revealed a ballooning of the left ventricle apex with dyskinesia of the mid and apical segments (ejection fraction 15%). Coronary angiography showed no abnormalities. Left ventriculography showed severe left ventricular (LV) systolic dysfunction with akinesia of the mid and apical LV segments and hyperdynamic basal segments. | |
| A presumptive diagnosis of Takotsubo syndrome secondary to benzodiazepine withdrawal was made. | |
| Day 0 (intensive care unit) | Administration of diazepam 10 mg intravenous (three times daily). |
| Day 7 | Hospital discharge, with alprazolam (2 mg/day). Follow-up transthoracic echocardiogram showed improvement of LV function with complete resolution of the wall motion abnormalities. |
| 6-month follow-up | Asymptomatic with a normal biventricular function. Beta-blocker was successfully introduced as part of a lifelong plan. |
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