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Review
. 2008 Nov;23(11):1904-8.
doi: 10.1007/s11606-008-0744-4. Epub 2008 Aug 8.

Takotsubo cardiomyopathy

Brett A Sealove  1 , Satish Tiyyagura, Valentin Fuster
Affiliations
Review

Takotsubo cardiomyopathy

Brett A Sealove et al. J Gen Intern Med. 2008 Nov.

Abstract

Background: Takotsubo cardiomyopathy is a novel, yet well-described, reversible cardiomyopathy triggered by profound psychological or physical stress with a female predominance.

Objective: This review is designed to increase general clinician awareness about the diagnosis, incidence, pathogenesis, and therapies of this entity.

Data sources: A complete search of multiple electronic databases (Pubmed, EMBASE, Science Citation Index) was carried out to identify all full-text, English-language articles published from 1980 to the present date and relevant to this review.

Review methods: The following search terms were used: takotsubo cardiomyopathy, stress-induced cardiomyopathy, and left ventricular apical ballooning syndrome. Citation lists from identified articles were subsequently reviewed and pertinent articles were further identified.

Results: Takotsubo cardiomyopathy is typically characterized by the following: 1) acute onset of ischemic-like chest pain or dyspnea, 2) transient apical and mid-ventricular regional wall-motion abnormality, 3) minor elevation of cardiac biomarkers, 4) dynamic electrocardiographic changes, and 5) the absence of epicardial coronary artery disease. The pathogenesis of the syndrome is unknown but has mostly been associated with acute emotional or physiologic stressors. Dote, Sato, Tateishi, Uchida, Ishihara (J Cardiol. 21(2):203-214, 1991); Desmet, Adriaenssens, Dens (Heart. 89(9):1027-1031, Sep., 2003); Bybee, Kara, Prasad, et al. (Ann Intern Med. 141(11):858-865, Dec 7, 2004); Sharkey, Lesser, Zenovich, et al. (Circulation. 111(4):472-479, Feb 1, 2005) The short and long-term prognosis of these patients is overwhelmingly favorable and often only requires supportive therapy.

Conclusion: Whether an emotional or physical event precedes one's symptoms, it is apparent that takotsubo cardiomyopathy case presentations mimic ST-segment elevation myocardial infarction, and thus is an important entity to be recognized by the medical community.

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Figures

Figure 1
Figure 1
ECG on initial presentation of patient M.G.
Figure 2
Figure 2
Left ventricular angiogram in diastole and systole. The findings illustrate normal basal function with severe hypokinesis of the anterolateral, apical, and inferoposterior segments (apical ballooning).
Figure 3
Figure 3
Follow up ECG one month later.
See this image and copyright information in PMC

Comment in

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