scholarly journals Takotsubo syndrome induced by brachytherapy in a patient with endocervical adenocarcinoma

2020 ◽  
Vol 6 (1) ◽  
Author(s):  
Aline Cristini Vieira ◽  
Mauricio Fernando Silva Almeida Ribeiro ◽  
Julianne Lima ◽  
Jacob Sessim Filho ◽  
Heloisa de Andrade Carvalho ◽  
...  
Keyword(s):  
Differential Diagnosis ◽  
Heart Function ◽  
Locally Advanced ◽  
Physical Stress ◽  
Left Ventricular ◽  
Cardiac Biomarkers ◽  
Public Health Issue ◽  
Apical Ballooning Syndrome ◽  
Takotsubo Syndrome ◽  
Low Middle Income Countries

Abstract Background Takotsubo syndrome (TTS), also known as stress cardiomyopathy, apical ballooning syndrome and broken heart syndrome, is characterized by acute-onset chest pain, electrocardiographic (ECG) abnormalities and reversible left ventricular (LV) disfunction in the absence of a culprit obstructive lesion in the coronary arteries; therefore, myocardial infarction is the most important differential diagnosis. Usually induced by emotional/physical stress, its treatment consists in hemodynamic support until complete and spontaneous recovery occurs, which is generally achieved within a few days to weeks. Cervical malignancies are an important public health issue in low/middle-income countries and, in the setting of locally advanced disease, concurrent chemoradiation followed by brachytherapy is considered the standard treatment, harboring curative potential. Case report We report a case of a 38-year-old woman who underwent concurrent chemoradiotherapy and developed cardiopulmonary arrest in ventricular fibrillation during a brachytherapy session. Complementary tests disclosed altered ECG and cardiac biomarkers, no evidence of coronary artery obstruction, as well as LV disfunction consistent with TTS on echocardiogram and cardiac MRI. After few days of supportive therapy, complete recovery of heart function was observed. Conclusions Especially for cancer patients, who usually experience intense emotional/physical stress intrinsically associated with their diagnosis and aggressive treatments, considering TTS as a differential diagnosis is warranted. Intracavitary brachytherapy procedure may represent a trigger for TTS.

scholarly journals Takotsubo Syndrome induced by brachytherapy in a patient with endocervical adenocarcinoma.

2020 ◽  
Author(s):  
Aline Cristini Vieira ◽  
Mauricio Fernando Silva Almeida Ribeiro ◽  
Julianne Lima ◽  
Jacob Sessim Filho ◽  
Heloisa de Andrade Carvalho ◽  
...  
Keyword(s):  
Differential Diagnosis ◽  
Heart Function ◽  
Locally Advanced ◽  
Physical Stress ◽  
Left Ventricular ◽  
Cardiac Biomarkers ◽  
Public Health Issue ◽  
Apical Ballooning Syndrome ◽  
Takotsubo Syndrome ◽  
Low Middle Income Countries

Abstract Background: Takotsubo syndrome (TTS), also known as stress cardiomyopathy, apical ballooning syndrome and broken heart syndrome, is characterized by acute-onset chest pain, electrocardiographic (ECG) abnormalities and reversible left ventricular (LV) disfunction in the absence of a culprit obstructive lesion in the coronary arteries; therefore, myocardial infarction is the most important differential diagnosis. Usually induced by emotional/physical stress, its treatment consists in hemodynamic support until complete and spontaneous recovery occurs, which is generally achieved within a few days to weeks. Cervical malignancies are an important public health issue in low/middle-income countries and, in the setting of locally advanced disease, concurrent chemoradiation followed by brachytherapy is considered the standard treatment, harboring curative potential. Case report: We report a case of a 38-year-old woman who underwent concurrent chemoradiotherapy and developed cardiopulmonary arrest in ventricular fibrillation during a brachytherapy session. Complementary tests disclosed altered ECG and cardiac biomarkers, no evidence of coronary artery obstruction, as well as LV disfunction consistent with TTS on echocardiogram and cardiac MRI. After few days of supportive therapy, complete recovery of heart function was observed. Conclusion: Especially for cancer patients, who usually experience intense emotional/physical stress intrinsically associated with their diagnosis and aggressive treatments, considering TTS as a differential diagnosis is warranted. Intracavitary brachytherapy procedure may represent a trigger for TTS.

scholarly journals Takotsubo Syndrome Induced by Brachytherapy in a Patient with Endocervical Adenocarcinoma.

2020 ◽  
Author(s):  
Aline Cristini Vieira ◽  
Mauricio Fernando Silva Almeida Ribeiro ◽  
Julianne Lima ◽  
Jacob Sessim Filho ◽  
Heloisa de Andrade Carvalho ◽  
...  
Keyword(s):  
Differential Diagnosis ◽  
Heart Function ◽  
Locally Advanced ◽  
Physical Stress ◽  
Left Ventricular ◽  
Cardiac Biomarkers ◽  
Public Health Issue ◽  
Apical Ballooning Syndrome ◽  
Takotsubo Syndrome ◽  
Low Middle Income Countries

Abstract Background: Takotsubo syndrome (TTS), also known as stress cardiomyopathy, apical ballooning syndrome and broken heart syndrome, is characterized by acute-onset chest pain, electrocardiographic (ECG) abnormalities and reversible left ventricular (LV) disfunction in the absence of a culprit obstructive lesion in the coronary arteries; therefore, myocardial infarction is the most important differential diagnosis. Usually induced by emotional/physical stress, its treatment consists in hemodynamic support until complete and spontaneous recovery occurs, which is generally achieved within a few days to weeks. Cervical malignancies are an important public health issue in low/middle-income countries and, in the setting of locally advanced disease, concurrent chemoradiation followed by brachytherapy is considered the standard treatment, harboring curative potential. Case report: We report a case of a 38-year-old woman who underwent concurrent chemoradiotherapy and developed cardiopulmonary arrest in ventricular fibrillation during a brachytherapy session. Complementary tests disclosed altered EKG and cardiac biomarkers, no evidence of coronary artery obstruction, as well as LV disfunction consistent with TTS on echocardiogram and cardiac MRI. After few days of supportive therapy, complete recovery of heart function was observed. Conclusion: considering that community clinicians might be unfamiliar with TTS, this condition is likely to be underdiagnosed. Especially for cancer patients, who usually experience intense emotional/physical stress intrinsically associated with their diagnosis and aggressive treatments, considering TTS as a differential diagnosis is warranted. Intracavitary brachytherapy procedure may represent a trigger for TTS.

scholarly journals Случай атипичной формы синдрома такоцубо у молодого мужчины

2017 ◽  
pp. 78-85
Keyword(s):  
Myocardial Infarction ◽  
Apical Ballooning ◽  
Left Ventricular ◽  
Apical Ballooning Syndrome ◽  
Takotsubo Syndrome ◽  
Ultrasound Diagnostics

Синдром такоцубо представляет собой транзиторное шаровидное расширение верхушки сердца с дисфункцией в ответ на интенсивный эмоциональный или физический стресс. Эти признаки напоминают инфаркт миокарда, однако при синдроме такоцубо отсутствуют признаки атеротромбоза коронарных артерий, а также их гемодинамически значимого стеноза. Представлены клинический случай атипичного течения синдрома с развитием некротического поражения верхушки левого желудочка, тромбоза его полости и формированием рубцового поля, а также краткий обзор литературы по соответствующей тематике. Ключевые слова: ультразвуковая диагностика, синдром такоцубо, шаровидная деформация верхушки левого желудочка, инфаркт миокарда, тромбоз левого желудочка, ultrasound diagnostics, takotsubo syndrome, apical ballooning syndrome, myocardial infarction, left ventricular thrombosis

scholarly journals Long-term injury after Takotsubo syndrome (stress cardiomyopathy)

2020 ◽  
Vol 22 (Supplement_E) ◽  
pp. E73-E78
Author(s):  
Gloria Vassiliki’ Coutsoumbas ◽  
Pamela Gallo ◽  
Silvia Zagnoni ◽  
Giuseppe Di Pasquale
Keyword(s):  
Cardiovascular Events ◽  
Recovery Period ◽  
Physical Stress ◽  
Left Ventricular ◽  
Major Adverse Cardiovascular Events ◽  
Takotsubo Syndrome ◽  
Severe Left Ventricular Dysfunction ◽  
Coronary Syndrome

Abstract Takotsubo syndrome is a clinical condition characterized by transient impairment of left ventricular contractility, in association with symptoms, increase in indices of myocardial necrosis, as well as electrocardiographic changes, but without a coronary culprit lesion, and often after a significant psychological or physical stress. Albeit very similar to acute coronary syndrome (ACS) as far as presentation and clinical course, Takotsubo syndrome was considered, up until recently, a condition with very favourable long-term prognosis, in view of the frequent complete functional recovery. More recently, several retrospective observational studies as well as registers, unexpectedly called attention to a significant incidence of major adverse cardiovascular events, not limited to the recovery period but also during the long-term follow-up, in a way very similar to the outcome of patients after ACS. Several negative prognostic factors have been isolated, such as physical stress as trigger of the condition, the presence of severe left ventricular dysfunction, and the consequent cardiogenic shock during the acute phase. These factors are able to classify better the patient’s prognosis, both in the short- and long-term, and identify patients requiring a more stringent clinical follow-up, considering the higher likelihood of adverse cardiovascular events.

scholarly journals Takotsubo syndrome after induction of general anesthesia: three clinical cases

2019 ◽  
Vol 47 (3) ◽  
pp. 236-243
Author(s):  
A. A. Klimov ◽  
M. Yu. Buldakov ◽  
M. V. Gritskevich ◽  
D. A. Zabaluev ◽  
S. A. Kamnev ◽  
...  
Keyword(s):  
Myocardial Ischemia ◽  
General Anesthesia ◽  
Critical Condition ◽  
Coronary Vessels ◽  
Apical Ballooning ◽  
Left Ventricular ◽  
Apical Ballooning Syndrome ◽  
Takotsubo Syndrome ◽  
Ventricular Failure ◽  
Favorable Prognosis

Takotsubo syndrome (stress-induced cardiomyopathy, or apical ballooning syndrome) is a  rare critical condition with approximate incidence of 0.00006% and relatively favorable prognosis. It is characterized by electrocardiographic signs of myocardial ischemia, as well as by severe left ventricular failure with intact coronary vessels. The literature on postoperative development of this disease is scarce. This paper presents three documented cases of takotsubo syndrome with favorable outcomes that developed just after the induction of general anesthesia.

scholarly journals Catecholamine-Induced Secondary Takotsubo Syndrome in Children With Severe Enterovirus 71 Infection and Acute Heart Failure: A 20-year Experience of a Single Institute

2021 ◽  
Vol 8 ◽  
Author(s):  
Sheng-Ling Jan ◽  
Yun-Ching Fu ◽  
Ching-Shiang Chi ◽  
Hsiu-Fen Lee ◽  
Fang-Liang Huang ◽  
...  
Keyword(s):  
Heart Failure ◽  
Acute Heart Failure ◽  
Life Support ◽  
Clinical Manifestations ◽  
Enterovirus 71 ◽  
Left Ventricular ◽  
Cardiac Biomarkers ◽  
Systemic Hypertension ◽  
Close Monitoring ◽  
Takotsubo Syndrome

Background: Acute heart failure (AHF) is the major cause of death in children with severe enterovirus 71 (EV71) infection. This study aimed to report our clinical experience with EV71-related AHF, as well as to discuss its pathogenesis and relationship to Takotsubo syndrome (TTS).Methods: A total 27 children with EV71-related AHF between 1998 and 2018 were studied. The TTS diagnosis was based on the International Takotsubo Diagnostic Criteria.Results: Acute heart failure-related early death occurred in 10 (37%) of the patients. Sinus tachycardia, systemic hypertension, and pulmonary edema in 100, 85, and 81% of the patients, respectively, preceded AHF. Cardiac biomarkers were significantly increased in most patients. The main echocardiographic findings included transient and reversible left ventricular (LV) regional wall motion abnormality (RWMA) with apical ballooning. High concentrations of catecholamines either preceded or coexisted with AHF. Myocardial pathology revealed no evidence of myocarditis, which was consistent with catecholamine-induced cardiotoxic damage. Patients with EV71-related AHF who had received close monitoring of their cardiac function, along with early intervention involving extracorporeal life support (ECLS), had a higher survival rate (82 vs. 30%, p = 0.013) and better neurological outcomes (59 vs. 0%, p = 0.003).Conclusion: EV 71-related AHF was preceded by brain stem encephalitis-related hypercatecholaminemia, which resulted in a high mortality rate. Careful monitoring is merited so that any life-threatening cardiogenic shock may be appropriately treated. In view of the similarities in their clinical manifestations, natural course direction, pathological findings, and possible mechanisms, TTS and EV71-related AHF may represent the same syndrome. Therefore, we suggest that EV71-related AHF could constitute a direct causal link to catecholamine-induced secondary TTS.

scholarly journals Overview of the Global Prevalence and Diagnostic Criteria of Takotsubo Syndrome

2021 ◽  
Author(s):  
Shogade Taiwo ◽  
Akpabio Akpabio
Keyword(s):  
Sympathetic Innervation ◽  
Apical Ballooning ◽  
Left Ventricular ◽  
Apical Ballooning Syndrome ◽  
Takotsubo Syndrome ◽  
Syndrome Patient ◽  
Cardiac Sympathetic Innervation ◽  
The World ◽  
Uncommon Disease ◽  
As Stress

Takotsubo syndrome (TTS) is an acute and reversible abnormal condition of the heart also known as stress cardiomyopathy, apical ballooning syndrome, or broken heart syndrome. It is an uncommon disease that mostly occurs among Asians though studies have shown its occurrence in other parts of the world. The typical takotsubo syndrome patient has a unique circumferential left ventricular contraction abnormality that extends beyond a coronary artery supply territory and appears to follow the anatomical cardiac sympathetic innervation.

scholarly journals Delayed onset Takotsubo syndrome following exercise ECG: a case report

2019 ◽  
Vol 3 (2) ◽  
Author(s):  
Aruni Ghose ◽  
Suvro Banerjee
Keyword(s):  
Chest Pain ◽  
Stress Test ◽  
Exercise Stress Test ◽  
Left Ventricular ◽  
Cardiac Biomarkers ◽  
Exercise Stress ◽  
Takotsubo Syndrome ◽  
Coronary Syndrome ◽  
Exercise Ecg ◽  
Emotional Trigger

Abstract Background Takotsubo syndrome usually occurs immediately following a physical or emotional trigger. In some cases, a triggering stress may not be evident. A delayed manifestation of the syndrome may account for such cases. Case summary An asymptomatic 69-year-old woman presented for a routine cardiac check-up, which revealed normal electrocardiogram (ECG), echocardiography, and exercise ECG. She did not complain of any chest pain during or immediately after the tests. After about 24 h, she developed chest pain for which she was admitted with the provisional diagnosis of acute coronary syndrome. ECG showed dynamic T-wave changes with QTc prolongation. Cardiac biomarkers were mildly elevated. Characteristic reversible left ventricular dysfunction in absence of coronary stenosis ultimately led to the diagnosis of Takotsubo syndrome. Discussion Our case represents a delayed occurrence of Takotsubo syndrome triggered by a treadmill exercise stress test, which manifested about 24 h following the stressor. Such delayed manifestation may account for those cases of Takotsubo syndrome where no immediate triggering stressor is evident.

scholarly journals What becomes of the broken-hearted? A typical case of Takotsubo cardiomyopathy

2008 ◽  
Vol 7 (3) ◽  
pp. 131-133
Author(s):  
Sreenivasan Shiva ◽  
◽  
Louise M Beckham ◽  
Geoff Dalton ◽  
◽  
...  
Keyword(s):  
Takotsubo Cardiomyopathy ◽  
Apical Ballooning ◽  
Left Ventricular ◽  
Typical Case ◽  
Cardiac Biomarkers ◽  
Apical Ballooning Syndrome ◽  
St Segment Elevation ◽  
Important Differential Diagnosis ◽  
St Segment ◽  
Electrocardiogram Ecg

Takotsubo cardiomyopathy (TC), or apical ballooning syndrome (ABS), is becoming an increasingly recognised entity. Usually preceded by emotional stress, it is characterised by chest pain associated with ST-segment elevation on the 12-lead electrocardiogram (ECG), elevated cardiac biomarkers, and reversible left ventricular (LV) apical hypokinesia, making it an important differential diagnosis for ST-segment elevation myocardial infarction (STEMI). We present a typical case of TC initially misdiagnosed and treated as a STEMI, fortunately with no adverse consequences…

scholarly journals The differential diagnostic value of selected cardiovascular biomarkers in Takotsubo syndrome

2021 ◽  
Author(s):  
Albert Topf ◽  
Moritz Mirna ◽  
Vera Paar ◽  
Lukas J. Motloch ◽  
Janine Grueninger ◽  
...  
Keyword(s):  
Differential Diagnosis ◽  
Bleeding Risk ◽  
Serum Levels ◽  
Diagnostic Value ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Takotsubo Syndrome ◽  
Ventricular Ejection Fraction ◽  
Coronary Syndrome ◽  
High Bleeding Risk

Abstract Introduction Takotsubo syndrome (TTS) is clinically indistinguishable from an acute coronary syndrome (ACS). In the absence of valid markers for differential diagnosis, coronary angiography has been indispensable. Methods In our study, we evaluated the serum levels of sST-2, GDF-15, suPAR and H-FABP in 92 patients with the suspicion of TTS (51 TTS and 41 ACS patients) and 40 gender matched controls (no coronary artery disease or signs of heart failure) at baseline. Results H-FABP was significantly higher in ACS patients compared to TTS patients. Even in in propensity score matching for left ventricular ejection fraction, sex and cardiovascular risk factors, differences in the plasma levels of H-FABP in the matched cohort of TTS vs ACS remained statistically significant. Whereas, sST-2 was significantly elevated in TTS patients. H-FABP was superior for prediction of an ACS with even higher accuracy than hs troponin in differential diagnosis (AUC 0.797, p ≤ 0.0001); the optimal cut off for discrimination towards a TTS was calculated as 2.93 ng/ml (sensitivity 70.0%, specificity 82.4%, PPV 75.7%, NPV 77.4%). sST-2 seemed most appropriate for identification of a TTS (AUC 0.653, p = 0.012). The optimal cut off for differential diagnosis was 11018.06 pg/ml (sensitivity 82.0%, specificity 51.2%, PPV 69.4%, NPV 71.9 %). Conclusion H-FABP and sST-2 are the most promising markers with better accuracy than preexisting biomarkers in differential diagnosis in our study and therefore, could be crucial for the guidance of treatment in patients with high bleeding risk, advanced renal failure or multimorbidity. Graphical abstract

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