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Review
. 2015 Jul;10(1):25-30.
doi: 10.15420/ecr.2015.10.01.25.

Takotsubo Cardiomyopathy

Esha Sachdev  1 , C Noel Bairey Merz  1 , Puja K Mehta  1
Affiliations
Review

Takotsubo Cardiomyopathy

Esha Sachdev et al. Eur Cardiol. 2015 Jul.

Abstract

Takotsubo cardiomyopathy (TTC) is an acute, stress-induced cardiomyopathy with an increased prevalence in post-menopausal women. The syndrome is most frequently precipitated by an acute emotional or physical stressor and mimics acute myocardial infarction with symptoms, electrocardiogram (ECG) changes and cardiac troponin elevation that are indistinguishable from those caused by plaque rupture or coronary thrombosis. Diagnosis of TTC is made when coronary angiography reveals no obstructive coronary artery disease and the left ventricle demonstrates apical ballooning and basal hypercontractility. Other ventricular patterns have also been described. An abnormal myocardial response to the catecholamine surge from an emotional or a physical stressor is implicated in the pathophysiology, but the reasons for the high prevalence of TTC presentations in post-menopausal women are unknown. Several mechanisms including multi-vessel coronary vasospasm, endothelial and coronary microvascular dysfunction and direct catecholamine toxicity have been proposed. No specific guidelines for treatment of TTC have been established, but treatment is based on the American Heart Association/American College of Cardiology guidelines for acute coronary syndrome/acute myocardial infarction and heart failure guidelines. In this review article, we discuss the characteristic clinical presentation of TTC and the commonly proposed mechanisms.

Keywords: Mental stress; catecholamine; women heart disease.

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Conflict of interest statement

Disclosure: Esha Sachdev, MD, C Noel Bairey Merz, MD, and Puja K Mehta, MD, have no conflicts of interest to declare.

Figures

Figure 1:
Figure 1:. Reported Stressors Preceding Onset of Takotsubo Cardiomyopathy
Figure 2:
Figure 2:. Mechanisms Implicated in TTC
See this image and copyright information in PMC

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