1887
  1. Home
  2. A-Z Publications
  3. Global Cardiology Science and Practice
  4. Volume 2013, Issue 2
  5. Article
Volume 2013, Issue 2
  • ISSN: 2305-7823
  • EISSN:

Abstract

Takotsubo cardiomyopathy (TTC) is a transient left ventricular dysfunction due to akinesia of the left-ventricular (LV) mid-apical segments (apical ballooning), which can cause severe reduction in LV systolic function. The typical clinical picture of TTC include chest pain, electrocardiographic changes consisting of mild ST-segment elevation followed by diffuse deep T-wave inversion, QTc interval prolongation and mild troponin release in the absence of significant coronary stenoses. The syndrome often affects post-menopausal women and is triggered by sympathetic overstimulation, like intense physical or emotional stress, so that it is called the “broken heart syndrome”. Although left-ventricular systolic dysfunction usually fully recovers within few days, heart failure can still complicate the early phase. We report a case of stress-induced cardiomyopathy that had full recovery after 4 weeks of follow up. The main electrocardiographic, angiographic and imaging features are discussed.

© 2013 Spadotto, Elmaghawry, Zorzi, Migliore, Marra, licensee Bloomsbury Qatar Foundation Journals.
Loading

Article metrics loading...

/content/journals/10.5339/gcsp.2013.22
2013-08-01
2025-05-21
Loading full text...

Full text loading...

/deliver/fulltext/gcsp/2013/2/gcsp.2013.22.html?itemId=/content/journals/10.5339/gcsp.2013.22&mimeType=html&fmt=ahah

References

  1. Madhavan M, Prasad A. Proposed Mayo Clinic criteria for the diagnosis of Tako-Tsubo cardiomyopathy and long-term prognosis. Herz. Jun 2010; 35:4:240–243
     [Google Scholar]
  2. Migliore F, Bilato C, Isabella G, Iliceto S, Tarantini G. Haemodynamic effects of acute intravenous metoprolol in apical ballooning syndrome with dynamic left ventricular outflow tract obstruction. Eur J Heart Fail. Mar 2010; 12:3:305–338
     [Google Scholar]
  3. Sharkey SW, Windenburg DC, Lesser JR, Maron MS, Hauser RG, Lesser JN, Haas TS, Hodges JS, Maron BJ. Natural history and expansive clinical profile of stress (tako-tsubo) cardiomyopathy. J Am Coll Cardiol. Jan 2010; 55:4:333–341
     [Google Scholar]
  4. Primus C, Auer J. Atypical “mid-ventricular” Tako-tsubo cardiomyopathy in a patient suffering from posttraumatic stress disorder: a case report. Wien klin Wochenschr. Sep 2011; 123:17–18:562–565
     [Google Scholar]
  5. Gaibazzi N, Vezzani A, Concari P, Malchiodi L, Reverberi C. Rare and atypical forms of Tako-Tsubo cardiomyopathy diagnosed by contrast-echocardiography during subarachnoid haemorrhage: confirming the appropriateness of the new Tako-Tsubo classification. Int J Cardiol. May 2011; 149:1:115–117
     [Google Scholar]
  6. Migliore F, Zorzi A, Perazzolo Marra M, Corbetti F, Corrado D, Iliceto S, Tarantini G. Typical and atypical Takotsubo syndrome in the same patient. Int J Cardiol. Jan 2013; 162:2:e28–e30
     [Google Scholar]
  7. Kurisu S, Inoue I, Kawagoe T, Ishihara M, Shimatani Y, Nakamura S, Yoshida M, Mitsuba N, Hata T, Sato H. Time course of electrocardiographic changes in patients with tako-tsubo syndrome: comparison with acute myocardial infarction with minimal enzymatic release. Circ J. Jan 2004; 68:1:77–81
     [Google Scholar]
  8. Zorzi A, Migliore F, Perazzolo Marra M, Tarantini G, Iliceto S, Corrado D. Electrocardiographic J waves as a hyperacute sign of Takotsubo syndrome. J Electrocardiol. Jul-Aug 2012; 45:4:353–356
     [Google Scholar]
  9. Schmalfuss C. Tako-tsubo cardiomyopathy and cardiac magnetic resonance imaging. Clin Cardiol. Mar 2011; 34:3:145–146
     [Google Scholar]
  10. Perazzolo Marra M, Zorzi A, Corbetti F, De Lazzari M, Migliore F, Tona F, Tarantini G, Iliceto S, Corrado D. Apicobasal gradient of left ventricular myocardial edema underlies transient T-wave inversion and QT interval prolongation (Wellens' ECG pattern) in Tako-Tsubo cardiomyopathy. Heart Rhythm. Jan 2013; 10:1:70–77
     [Google Scholar]
  11. Madias C, Fitzgibbons TP, Alsheikh-Ali AA, Bouchard JL, Kalsmith B, Garlitski AC, Tighe DA, Estes NAM, Aurigemma GP, Link MS. Acquired long QT syndrome from stress cardiomyopathy is associated with ventricular arrhythmias and torsades de pointes. Heart Rhythm. Apr 2011; 8:4:555–561
     [Google Scholar]
  12. Migliore F, Zorzi A, Peruzza F, Perazzolo Marra M, Tarantini G, Iliceto S, Corrado D. Incidence and management of life-threatening arrhythmias in Takotsubo syndrome. Int J Cardiol. 2013 Jun; 166:1:261–263, doi:10.1016/j.ijcard.2012.09.107. Epub Oct 23, 2012
     [Google Scholar]
  13. Parodi G, DelPace S, Salvadori C, Carrabba N, Olivotto I, Gensini GF. Left ventricular apical ballooning syndrome as a novel cause of acute mitral regurgitation. J Am Coll Cardiol. Aug 2007; 50:7:647–649
     [Google Scholar]
  14. Spadotto V, Zorzi A, ElMaghawry M, Meggiolaro M, Pittoni GM. Heart failure due to ‘stress cardiomyopathy’: a severe manifestation of the opioid withdrawal syndrome. Eur Heart J Acute Cardiovasc Care. Mar 2013; 2:1:84–87
     [Google Scholar]
  15. Marcovitz PA, Czako P, Rosenblatt S, Billecke SS. Pheochromocytoma presenting with Takotsubo syndrome. J Interv Cardiol. Oct 2010; 23:5:437–442
     [Google Scholar]
  16. Khoueiry G, AbiRafeh N, Azab B, Markman E, Waked A, Abourjaili G, Shariff M, Costantino T. Reverse Takotsubo cardiomyopathy in the setting of anaphylaxis treated with high-dose intravenous epinephrine. J Emerg Med. Jan 2013; 44:1:96–99
     [Google Scholar]
  17. Paur H, Wright PT, Sikkel MB, Tranter MH, Mansfield C, O'Gara P, Stuckey DJ, Nikolaev VO, Diakonov I, Pannell L, Gong H, Sun H, Peters NS, Petrou M, Zheng Z, Gorelik J, Lyon AR, Harding SE. High levels of circulating epinephrine trigger apical cardiodepression in a β2-adrenergic receptor/Gi-dependent manner: a new model of Takotsubo cardiomyopathy. Circulation. Aug 2012; 126:6:697–706
     [Google Scholar]
  18. Migliore F, Maffei E, Perazzolo Marra M, Bilato C, Napodano M, Corbetti F, Zorzi A, Andres AL, Sarais C, Cacciavillani L, Favaretto E, Martini C, Seitun S, Cademartiri F, Corrado D, Iliceto S, Tarantini G. LAD coronary artery myocardial bridging and apical ballooning syndrome. JACC Cardiovasc Imaging. Jan 2013; 6:1:32–41
     [Google Scholar]
/content/journals/10.5339/gcsp.2013.22
Loading
Apical ballooning with mid-ventricular obstruction: the many faces of Takotsubo cardiomyopathy
Global Cardiology Science and Practice 2013, 22 (2013); https://doi.org/10.5339/gcsp.2013.22
/content/journals/10.5339/gcsp.2013.22
/content/journals/10.5339/gcsp.2013.22
Loading

Data & Media loading...

Supplements

Supplementary File 1

  • Article Type: Research Article
Keyword(s): cardiomyopathy, electrocardiogram, myocardial edema, stress-induced, T-waves and Takotsubo
This is a required field
Please enter a valid email address
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error