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Journal of Medicine and Life 2020Takotsubo cardiomyopathy is a reversible cardiomyopathy with a unique morphological feature of the left ventricle characterized by an apical ballooning appearance known... (Review)
Review
Takotsubo cardiomyopathy is a reversible cardiomyopathy with a unique morphological feature of the left ventricle characterized by an apical ballooning appearance known for approximately known 25 years. Catecholamine drive plays an essential role in the pathogenesis and pathophysiology of Takotsubo cardiomyopathy; hence, it is also called stress cardiomyopathy. Physical stress could also have an impact and leads to a greater variety of characteristics in Takotsubo cardiomyopathy. Supportive and symptomatic medication remains the mainstay therapy with priority to improving the function of the left ventricle for several days and full recovery in 3-4 weeks. Due to its similarity with myocardial infarction, Takotsubo cardiomyopathy requires careful diagnosis and management for the best possible outcome.
Topics: Humans; Prognosis; Takotsubo Cardiomyopathy
PubMed: 32341693
DOI: 10.25122/jml-2018-0067 -
Journal of the American College of... Oct 2018Stress cardiomyopathy is an acute reversible heart failure syndrome initially believed to represent a benign condition due to its self-limiting clinical course, but now... (Review)
Review
Stress cardiomyopathy is an acute reversible heart failure syndrome initially believed to represent a benign condition due to its self-limiting clinical course, but now recognized to be associated with a non-negligible rate of serious complications such as ventricular arrhythmias, systemic thromboembolism, and cardiogenic shock. Due to an increased awareness and recognition, the incidence of stress cardiomyopathy has been rising (15-30 cases per 100,000 per year), although the true incidence is unknown as the condition is likely underdiagnosed. Stress cardiomyopathy represents a form of neurocardiogenic myocardial stunning, and while the link between the brain and the heart is established, the exact pathophysiological mechanisms remain unclear. We herein review the proposed risk factors and triggers for the syndrome and discuss a practical approach to diagnosis and treatment of the patients with stress cardiomyopathy, highlighting potential challenges and unresolved questions.
Topics: Diagnostic Errors; Disease Management; Humans; Incidence; Risk Factors; Takotsubo Cardiomyopathy
PubMed: 30309474
DOI: 10.1016/j.jacc.2018.07.072 -
Heart (British Cardiac Society) Sep 2017
Review
Topics: Animals; Behavior Therapy; Cardiovascular Agents; Diagnostic Imaging; Electrocardiography; Humans; Stress, Psychological; Takotsubo Cardiomyopathy
PubMed: 28839096
DOI: 10.1136/heartjnl-2016-309783 -
Clinical Autonomic Research : Official... Feb 2018Takotsubo syndrome is a recently recognized acute cardiac disease entity with a clinical presentation resembling that of an acute coronary syndrome. The typical... (Review)
Review
Takotsubo syndrome is a recently recognized acute cardiac disease entity with a clinical presentation resembling that of an acute coronary syndrome. The typical takotsubo syndrome patient has a unique circumferential left (bi-) ventricular contraction abnormality profile that extends beyond a coronary artery supply territory and appears to follow the anatomical cardiac sympathetic innervation. The syndrome predominantly affects postmenopausal women and is often preceded by emotional or physical stress. Patients with predisposing factors such as malignancy and other chronic comorbidities are more prone to suffer from takotsubo syndrome. The pathogenesis of takotsubo syndrome is elusive. Several pathophysiological mechanisms involving myocardial ischemia (multivessel coronary artery spasm, microvascular dysfunction, aborted myocardial infarction), left ventricular outlet tract obstruction, blood-borne catecholamine myocardial toxicity, epinephrine-induced switch in signal trafficking, and autonomic nervous system dysfunction have been proposed. The syndrome is usually reversible; nevertheless, during the acute stage, a substantial number of patients develop severe complications such as arrhythmias, heart failure including pulmonary edema and cardiogenic shock, thromboembolism, cardiac arrest, and rupture. Treatment of precipitating factors, predisposing diseases, and complications is fundamental during the acute stage of the disease. The epidemiology, pathogenesis, and management of takotsubo syndrome are reviewed in this paper.
Topics: Humans; Takotsubo Cardiomyopathy
PubMed: 28917022
DOI: 10.1007/s10286-017-0465-z -
European Heart Journal Jun 2018The clinical expert consensus statement on takotsubo syndrome (TTS) part II focuses on the diagnostic workup, outcome, and management. The recommendations are based on...
The clinical expert consensus statement on takotsubo syndrome (TTS) part II focuses on the diagnostic workup, outcome, and management. The recommendations are based on interpretation of the limited clinical trial data currently available and experience of international TTS experts. It summarizes the diagnostic approach, which may facilitate correct and timely diagnosis. Furthermore, the document covers areas where controversies still exist in risk stratification and management of TTS. Based on available data the document provides recommendations on optimal care of such patients for practising physicians.
Topics: Algorithms; Arrhythmias, Cardiac; Computed Tomography Angiography; Coronary Angiography; Disease Management; Echocardiography; Electrocardiography; Humans; Magnetic Resonance Imaging; Myocardial Perfusion Imaging; Recurrence; Takotsubo Cardiomyopathy; Treatment Outcome
PubMed: 29850820
DOI: 10.1093/eurheartj/ehy077 -
European Heart Journal Jun 2018Takotsubo syndrome (TTS) is a poorly recognized heart disease that was initially regarded as a benign condition. Recently, it has been shown that TTS may be associated...
Takotsubo syndrome (TTS) is a poorly recognized heart disease that was initially regarded as a benign condition. Recently, it has been shown that TTS may be associated with severe clinical complications including death and that its prevalence is probably underestimated. Since current guidelines on TTS are lacking, it appears timely and important to provide an expert consensus statement on TTS. The clinical expert consensus document part I summarizes the current state of knowledge on clinical presentation and characteristics of TTS and agrees on controversies surrounding TTS such as nomenclature, different TTS types, role of coronary artery disease, and etiology. This consensus also proposes new diagnostic criteria based on current knowledge to improve diagnostic accuracy.
Topics: Age Distribution; Catecholamines; Coronary Artery Disease; Coronary Vasospasm; Humans; Mental Disorders; Microcirculation; Nervous System Diseases; Plaque, Atherosclerotic; Risk Factors; Sex Distribution; Takotsubo Cardiomyopathy; Terminology as Topic
PubMed: 29850871
DOI: 10.1093/eurheartj/ehy076 -
Texas Heart Institute Journal Jun 2014
Topics: Age Factors; Diagnostic Imaging; Electrocardiography; Female; Heart Rate; Humans; Male; Predictive Value of Tests; Risk Factors; Sex Factors; Takotsubo Cardiomyopathy; Treatment Outcome; Ventricular Function, Left
PubMed: 24955046
DOI: 10.14503/THIJ-14-4108 -
International Heart Journal 2022
Topics: Cardiomyopathies; Female; Humans; Peripartum Period; Pregnancy; Pregnancy Complications, Cardiovascular; Takotsubo Cardiomyopathy
PubMed: 35908852
DOI: 10.1536/ihj.22-133 -
European Journal of Heart Failure Jan 2016Takotsubo syndrome is an acute reversible heart failure syndrome that is increasingly recognized in modern cardiology practice. This Position Statement from the European... (Review)
Review
Current state of knowledge on Takotsubo syndrome: a Position Statement from the Taskforce on Takotsubo Syndrome of the Heart Failure Association of the European Society of Cardiology.
Takotsubo syndrome is an acute reversible heart failure syndrome that is increasingly recognized in modern cardiology practice. This Position Statement from the European Society of Cardiology Heart Failure Association provides a comprehensive review of the various clinical and pathophysiological facets of Takotsubo syndrome, including nomenclature, definition, and diagnosis, primary and secondary clinical subtypes, anatomical variants, triggers, epidemiology, pathophysiology, clinical presentation, complications, prognosis, clinical investigations, and treatment approaches. Novel structured approaches to diagnosis, risk stratification, and management are presented, with new algorithms to aid decision-making by practising clinicians. These also cover more complex areas (e.g. uncertain diagnosis and delayed presentation) and the management of complex cases with ongoing symptoms after recovery, recurrent episodes, or spontaneous presentation. The unmet needs and future directions for research in this syndrome are also discussed.
Topics: Cardiology; Disease Management; Europe; Humans; Prognosis; Risk Assessment; Risk Factors; Societies, Medical; Takotsubo Cardiomyopathy
PubMed: 26548803
DOI: 10.1002/ejhf.424 -
Medical Hypotheses Jan 2021Takotsubo cardiomyopathy (TTS), known as stress cardiomyopathy, is a rare disorder characterized by acute and transient left ventricular systolic and diastolic... (Review)
Review
Takotsubo cardiomyopathy (TTS), known as stress cardiomyopathy, is a rare disorder characterized by acute and transient left ventricular systolic and diastolic dysfunction, often associated with a stressful, emotional or physical event. TTS may be closely related to SARS-CoV-2 infection and the ongoing pandemic. The enormous emotional stress caused by the pandemic and respiratory infections caused by SARS-CoV-2 could be potential triggers for TTS. The case series cited above implicates that TTS should be considered in the differential diagnosis across the entire spectrum of myocardial injury in SARS-CoV-2 infected patients. Myocardial damage associated with SARS-CoV-2 infection is usually attributed to sepsis, hypoxemia, coronary artery disease, and myocarditis. We hypothesize that TTS may also play a role among these lesions.
Topics: Aged; Aged, 80 and over; COVID-19; Diagnosis, Differential; Female; Humans; Male; Middle Aged; Models, Cardiovascular; Pandemics; Risk Factors; SARS-CoV-2; Stress, Physiological; Stress, Psychological; Takotsubo Cardiomyopathy
PubMed: 33338954
DOI: 10.1016/j.mehy.2020.110454