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    "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">We thank Gulgun et al&#46;<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a> very much for their interest in our paper and for their important remarks&#46; We would like to make the following response&#58;</p><p id="par0010" class="elsevierStylePara elsevierViewall">Our patient underwent clinical follow-up at 3&#44; 6 and 12 months after the hospital admission and yearly thereafter&#46; Echocardiography was performed at 6 months and 12 months&#46;</p><p id="par0015" class="elsevierStylePara elsevierViewall">Regarding diastolic dysfunction&#44; she had grade 1 diastolic dysfunction at discharge&#44; which was no longer present at 6-month follow-up&#46; She never experienced any symptoms or signs of heart failure at any point during the course of the disease&#46;</p><p id="par0020" class="elsevierStylePara elsevierViewall">With respect to psychiatric evaluation&#44; while one should certainly be aware of the possible existence of clinically unapparent underlying disorders&#44; our patient did not experience any psychogenic stressful event&#44; had no symptoms suggestive of past or present psychiatric disease&#44; and never used any psychoactive drugs&#46; Furthermore&#44; the fact that we felt that the cause of her stress cardiomyopathy might have been the acute coronary syndrome she suffered further strengthened our clinical impression&#46; We therefore did not consider that referring the patient for psychiatric evaluation was necessary&#46; The fact that she has fared well over the course of more than two years supports our initial judgment&#46; Hence&#44; while requesting a psychiatric evaluation should always be considered&#44; especially if a psychogenic stressor was present&#44; we do not believe it should be undertaken on a routine basis&#46;</p><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Conflicts of interest</span><p id="par0025" class="elsevierStylePara elsevierViewall">The authors have no conflicts of interest to declare&#46;</p></span></span>"
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Letter to the Editor
Response to the Letter to the Editor “Delayed diastolic recovery and more prevalent psychiatric disorders in Takotsubo cardiomyopathy”
Resposta à Carta ao Editor «Recuperação diastólica tardia e alteração psiquiátrica mais prevalente na miocardiopatia da Takotsubo»
Miguel Nobre Menezesa,b,
Corresponding author
mnmenezes.gm@gmail.com

Corresponding author.
, Doroteia Silvaa,b, Ana Gomes Almeidaa,b, Fausto José Pintoa,b, Dulce Britoa,b
a Serviço de Cardiologia, Hospital de Santa Maria, CHLN, Lisboa, Portugal
b Faculdade de Medicina de Lisboa, Lisboa, Portugal
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    "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">We thank Gulgun et al&#46;<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a> very much for their interest in our paper and for their important remarks&#46; We would like to make the following response&#58;</p><p id="par0010" class="elsevierStylePara elsevierViewall">Our patient underwent clinical follow-up at 3&#44; 6 and 12 months after the hospital admission and yearly thereafter&#46; Echocardiography was performed at 6 months and 12 months&#46;</p><p id="par0015" class="elsevierStylePara elsevierViewall">Regarding diastolic dysfunction&#44; she had grade 1 diastolic dysfunction at discharge&#44; which was no longer present at 6-month follow-up&#46; She never experienced any symptoms or signs of heart failure at any point during the course of the disease&#46;</p><p id="par0020" class="elsevierStylePara elsevierViewall">With respect to psychiatric evaluation&#44; while one should certainly be aware of the possible existence of clinically unapparent underlying disorders&#44; our patient did not experience any psychogenic stressful event&#44; had no symptoms suggestive of past or present psychiatric disease&#44; and never used any psychoactive drugs&#46; Furthermore&#44; the fact that we felt that the cause of her stress cardiomyopathy might have been the acute coronary syndrome she suffered further strengthened our clinical impression&#46; We therefore did not consider that referring the patient for psychiatric evaluation was necessary&#46; The fact that she has fared well over the course of more than two years supports our initial judgment&#46; Hence&#44; while requesting a psychiatric evaluation should always be considered&#44; especially if a psychogenic stressor was present&#44; we do not believe it should be undertaken on a routine basis&#46;</p><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Conflicts of interest</span><p id="par0025" class="elsevierStylePara elsevierViewall">The authors have no conflicts of interest to declare&#46;</p></span></span>"
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Article information
ISSN: 21742049
Original language: English
DOI:10.1016/j.repce.2016.06.001
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