Novel Psychotherapeutic Approach in the Treatment of Recurrences of Takotsubo Syndrome

Background: Takotsubo Syndrome (TTS) is an acute coronary syndrome, resembling acute myocardial infarction, due to reversible microvascular constriction producing transient myocardial dysfunction. It mainly affects post-menopausal women after stress, trauma, or mourning. TTS may be lethal and recurrent despite complete medical therapy. For the first time, we propose a psychotherapeutic approach to prevent recurrences of TTS. Methods: Patients with recurrent TTS underwent psychodynamic psychotherapy according to Mutative Psychoanalytic Process (MPP), a novel psychotherapeutic intervention aiming to induce an evolutionary change in the patient’s mental processes. We report an example case. Result: In this TTS patient treated by PMP, the model allowed an early identification of the personality structure, as neurotic character, with consequent representation in the therapist’s mind of the distress and defensive mechanisms of the patient. The therapist eluded the patient’s trial to establish a relationship model well known to her, thus producing an effective evolutionary change in the patient’s mind. The patient concluded a successful cycle of psychotherapeutic treatments and has remained free of cardiac symptoms since. Conclusion: This initial psychotherapeutic experience confirms the psychodynamic genesis of cardiac pathology and opens a new frontier for studies in this area. Which personality profile is more likely associated with TTS, if it can predispose to such cardiac syndrome, and if MPP is the ideal treatment for these patients remains to be demonstrated in a larger study population.