LETTER
Domestic Violence May Trigger Takotsubo To the Editor: In the August 2014 issue of The American Journal of Medicine, Pelliccia et al1 discuss Takotsubo syndrome, or stress cardiomyopathy, a condition triggered by acute stress that affects almost exclusively women. While the authors claim that the stressful “triggers have been identified,” their list of triggers omits a potentially important and prevalent stressor in women’s lives that merits closer attention. Domestic violence against women, whether intimate partner violence or elder abuse, is prevalent. In the US, a national survey by the Centers for Disease Control and Prevention and the National Institute of Justice in 20102 reported that 36% of women age 18 years and older had experienced rape, physical violence, or stalking in their lifetime; in the past year alone, 6% reported experiencing these stressors at the hand of an intimate partner. Elder abuse is also common: the 2008 National Elder Abuse Survey found that 5% of adults age 60 years and older experienced emotional abuse and 2% physical abuse in the past year.3 As prevalent as domestic violence is, it is often overlooked in clinical history taking. The need for routine screening and intervention for domestic violence in women was recently underscored by guidance from the United States Preventive Services Task Force, the Health Resources and Services Administration, and the Institute of Medicine that screening for domestic violence be included as part of women’s preventive health care.4-6 We urge researchers and clinicians to inquire about intimate partner violence or elder abuse when Funding: None. Conflict of Interest: None. Authorship: All authors had access to the data and role in writing the manuscript.
0002-9343/$ -see front matter Ó 2015 Elsevier Inc. All rights reserved.
studying or treating women with Takotsubo syndrome; doing so may offer new insights into the most relevant and common stress triggers that affect women’s hearts. Janet W. Rich-Edwards, ScDa Brigid R. McCaw, MDb Annie Lewis-O’Connor, PhD, NNP-BC, MPHc a Connors Center for Women’s Health and Gender Biology Brigham and Women’s Hospital and Harvard Medical School Boston, Mass b Department of Internal Medicine Kaiser Permanente Richmond, Calif c Center for Women and Newborns Brigham and Women’s Hospital and Harvard Medical School Boston, Mass
http://dx.doi.org/10.1016/j.amjmed.2014.10.051
References 1. Pelliccia F, Greco C, Vitale C, Rosano G, Gaudio C, Kaski JC. Takotsubo syndrome (stress cardiomyopathy): an intriguing clinical condition in search of its identity. Am J Med. 2014;127:699-704. 2. Black MC, Basile KC, Breiding MJ, et al. The National Intimate Partner and Sexual Violence Survey: 2010 Summary Report. Atlanta, GA: National Center for Injury Prevention and Control, Centers for Disease Control and Prevention; 2011. 3. Acierno R, Hernandez MA. Prevalence and correlates of emotional, physical, sexual, and financial abuse and potential neglect in the United States: the National Elder Mistreatment Study. Am J Public Health. 2010;100:292-297. 4. Institute of Medicine. Clinical Preventive Services for Women: Closing the Gaps. Washington, DC: The National Academies Press; 2011. 5. Health Resources and Services Administration, U.S. Department of Health and Human Services. Women’s preventive services guidelines. Available at: http://www.hrsa.gov/womensguidelines/. Accessed August 28, 2014. 6. U.S. Preventive Services Task Force. Intimate partner violence and abuse of elderly and vulnerable adults: screening. Available at: http://www. uspreventiveservicestaskforce.org/uspstf12/ipvelder/ipvelderfinalrs.htm. Accessed August 28, 2014.
Domestic Violence May Trigger Takotsubo To the Editor: In the August 2014 issue of The American Journal of Medicine, Pelliccia et al1 discuss Takotsubo syndrome, or stress cardiomyopathy, a condition triggered by acute stress that affects almost exclusively women. While the authors claim that the stressful “triggers have been identified,” their list of triggers omits a potentially important and prevalent stressor in women’s lives that merits closer attention. Domestic violence against women, whether intimate partner violence or elder abuse, is prevalent. In the US, a national survey by the Centers for Disease Control and Prevention and the National Institute of Justice in 20102 reported that 36% of women age 18 years and older had experienced rape, physical violence, or stalking in their lifetime; in the past year alone, 6% reported experiencing these stressors at the hand of an intimate partner. Elder abuse is also common: the 2008 National Elder Abuse Survey found that 5% of adults age 60 years and older experienced emotional abuse and 2% physical abuse in the past year.3 As prevalent as domestic violence is, it is often overlooked in clinical history taking. The need for routine screening and intervention for domestic violence in women was recently underscored by guidance from the United States Preventive Services Task Force, the Health Resources and Services Administration, and the Institute of Medicine that screening for domestic violence be included as part of women’s preventive health care.4-6 We urge researchers and clinicians to inquire about intimate partner violence or elder abuse when Funding: None. Conflict of Interest: None. Authorship: All authors had access to the data and role in writing the manuscript.
0002-9343/$ -see front matter Ó 2015 Elsevier Inc. All rights reserved.
studying or treating women with Takotsubo syndrome; doing so may offer new insights into the most relevant and common stress triggers that affect women’s hearts. Janet W. Rich-Edwards, ScDa Brigid R. McCaw, MDb Annie Lewis-O’Connor, PhD, NNP-BC, MPHc a Connors Center for Women’s Health and Gender Biology Brigham and Women’s Hospital and Harvard Medical School Boston, Mass b Department of Internal Medicine Kaiser Permanente Richmond, Calif c Center for Women and Newborns Brigham and Women’s Hospital and Harvard Medical School Boston, Mass
http://dx.doi.org/10.1016/j.amjmed.2014.10.051
References 1. Pelliccia F, Greco C, Vitale C, Rosano G, Gaudio C, Kaski JC. Takotsubo syndrome (stress cardiomyopathy): an intriguing clinical condition in search of its identity. Am J Med. 2014;127:699-704. 2. Black MC, Basile KC, Breiding MJ, et al. The National Intimate Partner and Sexual Violence Survey: 2010 Summary Report. Atlanta, GA: National Center for Injury Prevention and Control, Centers for Disease Control and Prevention; 2011. 3. Acierno R, Hernandez MA. Prevalence and correlates of emotional, physical, sexual, and financial abuse and potential neglect in the United States: the National Elder Mistreatment Study. Am J Public Health. 2010;100:292-297. 4. Institute of Medicine. Clinical Preventive Services for Women: Closing the Gaps. Washington, DC: The National Academies Press; 2011. 5. Health Resources and Services Administration, U.S. Department of Health and Human Services. Women’s preventive services guidelines. Available at: http://www.hrsa.gov/womensguidelines/. Accessed August 28, 2014. 6. U.S. Preventive Services Task Force. Intimate partner violence and abuse of elderly and vulnerable adults: screening. Available at: http://www. uspreventiveservicestaskforce.org/uspstf12/ipvelder/ipvelderfinalrs.htm. Accessed August 28, 2014.
