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Review
. 2019 Jul 1:5:7.
doi: 10.1186/s40959-019-0042-9. eCollection 2019.

Takotsubo cardiomyopathy in cancer patients

Aakash Desai  1 , Arish Noor  1 , Saurabh Joshi  1   2 , Agnes S Kim  1   2
Affiliations
Review

Takotsubo cardiomyopathy in cancer patients

Aakash Desai et al. Cardiooncology. .

Abstract

Background: Cancer is a chronic condition that induces significant emotional and physical stress, which may increase the risk for developing Takotsubo cardiomyopathy (TCM).

Main body: Takotsubo cardiomyopathy, also known as stress cardiomyopathy, is a clinical syndrome that generally presents as chest pain mimicking acute coronary syndrome or as an acute heart failure characterized by severe left ventricular systolic dysfunction in response to emotional, physical, or medical stress. The potential triggers for Takotsubo syndrome in cancer patients include the emotional turmoil of a cancer diagnosis, the inflammatory state of the cancer itself, and the physical stress of cancer surgery, systemic anti-neoplastic therapy, and radiation treatment. TCM is becoming increasingly recognized among patients with cancer and has been associated with adverse outcomes in this patient population. In this study, we searched the Pubmed database using keywords "Takotsubo cardiomyopathy", "cancer", and "anti-neoplastic therapy" to review case reports of Takotsubo syndrome occurring in oncologic patients after systemic anti-neoplastic therapy. Clinical presentation, electrocardiogram, laboratory data, transthoracic echocardiogram and coronary angiogram results, and patient outcomes were collected and analyzed.

Conclusion: Patients with cancer are at an elevated risk for developing stress cardiomyopathy, and it is important to know which cancer drugs have been associated with the development of the Takotsubo syndrome.

Keywords: Cancer; Chemotherapy; Stress cardiomyopathy; Takotsubo cardiomyopathy.

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Conflict of interest statement

Competing interestsThe authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Echocardiogram pattern in a patient with TCM demonstrating apical ballooning and diffuse hypokinesis with sparing of the basal myocardial segments. Left ventricle in (a) end-diastole and (b) end-systole is shown; Left Ventriculogram pattern in TCM shown in (c) end-diastole and (d) end-systole
Fig. 2
Fig. 2
Proposed Pathogenetic Mechanisms of TCM
Fig. 3
Fig. 3
Cancer and Takotsubo cardiomyopathy: Cancer can increase the predisposition to TCM through various pathways. Cancer produces an emotional stress response as well as physical/surgical stressors from the disease. The paraneoplastic mediators along with the chronic inflammatory state is another risk factor. Lastly, the therapeutic regimens including medical therapeutic agents and radiation therapy can trigger the development of TCM
See this image and copyright information in PMC

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