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. 2024 Aug 12;12(16):1602.
doi: 10.3390/healthcare12161602.

Takotsubo Syndrome: Differences between Peripartum Period and General Population

Stavros Tzerefos  1 , Dimitra Aloizou  1 , Sofia Nikolakopoulou  2 , Stavros Aloizos  1
Affiliations

Takotsubo Syndrome: Differences between Peripartum Period and General Population

Stavros Tzerefos et al. Healthcare (Basel). .

Abstract

Takotsubo syndrome (TTS) was first described in postmenopausal women with transient regional wall motion abnormalities. The trigger is usually an emotional or physical stress. The catecholamine hypothesis seems to be the most prevailing. The main difference between TTS and acute coronary syndromes is that there is no obstructive coronary disease to explain the regional abnormalities. In this form, the left ventricle resembles the fishing jar which is used to trap octopus in Japan. However, to date more atypical forms are recognized. Also, the syndrome is not limited to older women. Nowadays, TTS is presented even in pregnancy and postpartum females. Our experience revealed cases of patients during these periods and some of them suffered from reverse Takotsubo. Additionally, the initial diagnosis in some patients was other than TTS. Due to these findings, we suggest that this type of TTS is not very rare but underestimated. For this reason, further studies are needed to support and explain this condition.

Keywords: peripartum stress-induced cardiomyopathy; pregnancy; reverse takotsubo syndrome.

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Conflict of interest statement

The authors declare no conflicts of interest.

Figures

Figure 1
Figure 1
The Japanese octopus trap (right). Adapted from Santos I.
Figure 2
Figure 2
Abnormal ECG in peripartum women with TTS.
Figure 3
Figure 3
Four chambers in TTS patient at systole.
Figure 4
Figure 4
Normal coronary angiography in patient with TTS.
Figure 5
Figure 5
MRI image in apical balloon TTS during systole.
Figure 6
Figure 6
The four different types of Takotsubo syndrome. (A) Normal ventriculography. (B) Apical TTS. (C) Midventricular TTS. (D) Basal–Reverse TTS. (E) Focal TTS.
Figure 7
Figure 7
Diagnostic algorithm of Takotsubo syndrome. ACS, acute coronary syndrome; CAD, coronary artery disease; CCTA, coronary computed tomography angiography; CMR, cardiac magnetic resonance; ECG, electrocardiogram; InterTAK, International Takotsubo Registry; RWMA, regional wall motion abnormality; TTE, transthoracic echocardiography; TTS, Takotsubo syndrome.
See this image and copyright information in PMC

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