Transesophageal echocardiography (TEE) disclosed Takotsubo syndrome in the midesophageal two-chamber view and inotropic agents initiated because of left ventricular dysfunction

The pathogenesis of takotsubo syndrome can be considered the result of a catecholamine surge that, in predisposed and susceptible individuals, produces microvascular spasm responsible for myocardial dysfunction. The reversibility of microvascular dysfunction along with the activation of the cell survival cascade guarantees prompt and complete functional recovery in the majority of patients. Yet, about 20% of patients have serious in-hospital complications probably related to the severity of left ventricular dysfunction and/or lack of resolution. The reasons for these different outcomes are still unknown.

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Stress Cardiomyopathy in COVID-19 Disease

European Journal of Case Reports in Internal Medicine ◽

10.12890/2020_001718 ◽

2020 ◽

Author(s):

Maria Cristina Pasqualetto ◽

Eleonora Secco ◽

Manuele Nizzetto ◽

Moreno Scevola ◽

Lorella Altafini ◽

...

Keyword(s):

Coronary Angiography ◽

Left Ventricular Dysfunction ◽

Ventricular Dysfunction ◽

Left Ventricular ◽

Stress Cardiomyopathy ◽

The Other ◽

Takotsubo Syndrome ◽

Virus Spread ◽

Clinical Presentations

Patients affected by COVID-19 pneumonia may develop stress cardiomyopathy, also known as Takotsubo syndrome (TTS), at different stages during the disease and with different degrees of left ventricular dysfunction. We describe three cases of TTS in COVID-19-positive patients with different clinical presentations and outcomes. One of them died, while in the other two coronary angiography confirmed the diagnosis but was postponed until after pneumonia resolution because of the risk of virus spread.

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Acute left ventricular dysfunction complicating pregnancy on ECMO: Tri-iodothyronine to the rescue with real time transesophageal echocardiography

Journal of Cardiology Cases ◽

10.1016/j.jccase.2015.09.005 ◽

2016 ◽

Vol 13 (1) ◽

pp. 33-36 ◽

Cited By ~ 1

Author(s):

Gautam K. Visveswaran ◽

Claudia Gidea ◽

David Baran ◽

Marc Cohen ◽

Mark J. Zucker

Keyword(s):

Transesophageal Echocardiography ◽

Real Time ◽

Left Ventricular Dysfunction ◽

Ventricular Dysfunction ◽

Left Ventricular

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Le syndrome de Takotusbo (STK)

Médecine Intensive Réanimation ◽

10.37051/mir-00008 ◽

2020 ◽

Vol 29 (2) ◽

pp. 65-74

Author(s):

Christian Richard

Keyword(s):

Left Ventricular Dysfunction ◽

Initial Phase ◽

Ventricular Dysfunction ◽

Left Ventricular ◽

Prise En Charge ◽

Single Coronary Artery ◽

Takotsubo Syndrome ◽

Severe Left Ventricular Dysfunction ◽

Coronary Syndrome ◽

Ventriculaire Gauche

Décrit initialement par des auteurs japonais dans les années 1990 le Syndrome de Takotsubo se présente comme un infarctus du myocarde associé à une dysfonction ventriculaire gauche sévère. La coronarographie est en général normale et la dysfonction ventriculaire gauche s’étend au-delà d’un territoire concerné par une seule artère coronaire. Les causes et la physiopathologie du Syndrome de Takotsubo restent à ce jour mal identifiées et comprises. En dépit de la survenue de complications cardio-vasculaires à la phase initiale chez les patients à risque élevé, le pronostic reste en général excellent même si les études les plus récemment publiées suggèrent la possibilité de séquelles et de récurrence. Les critères diagnostiques du Syndrome de Takotsubo ont été récemment publiés par la Société Européenne de Cardiologie afin d’éliminer l’existence d’un syndrome coronarien aigu et d’une myocardite. L’existence de Syndrome de Takotsubo primaire et secondaire a été rapportée et une stratification en risque modéré et élevé proposée. La prescription classique de beta bloquants tant en chronique qu’en aigu lorsqu’elle n’est pas contre indiquée est aujourd’hui remise en question au vu des résultats négatifs d’études prospectives récemment publiées. Des essais contrôlés randomisés et un suivi de cohorte précis sont nécessaires pour définir les modalités de la prise en charge thérapeutique et du suivi. Initially described by Japanese authors in the 1990s Takotsubo Syndrome presents as an acute myocardial infarction associated with severe left ventricular dysfunction. Coronary angiogram is generally within normal limits and left ventricular dysfunction extends beyond the territory concerned by a single coronary artery. The cause and pathogenesis of Takotsubo syndrome remain poorly understood. Despite the onset of complications at the initial phase in some high risk patients the prognosis is usually benign but the most recently published studies suggest the possibility of sequelae and recurrences. Diagnostic criteria for Takotsubo Syndrome have been recently published by the European Society of Cardiology in order to eliminate acute coronary syndrome and myocarditis. Primary and secondary Takotsubo Syndromes were reported and risk stratification was defined. The widely reported indication for beta blockers for the treatment of Takotsubo syndrome even at the initial phase of the disease was recently challenged by the negative results of prospective studies. Randomized controlled trials are needed to provide a stronger evidence base for decision-making.

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