scholarly journals Tako-Tsubo syndrome. Approach to the subject and Report of 2 cases

2021 ◽  
Vol 4 (4) ◽  
pp. 01-05
Author(s):  
Claribel Pazos
Keyword(s):  
Heart Failure ◽  
Apical Ballooning ◽  
Stress Cardiomyopathy ◽  
Takotsubo Syndrome ◽  
Angiographic Study ◽  
Subsequent Recovery ◽  
Coronary Syndrome ◽  
Electrocardiographic Changes ◽  
The Subject ◽  
Anterior Infarction

Takotsubo syndrome, or stress cardiomyopathy, is a relatively rare transient and reversible cardiomyopathy, although its diagnosis has increased in recent years, it presents as an acute coronary syndrome (ACS) or acute heart failure, its incidence is unknown exactly in Latin America and in Cuba. We present 2 cases seen in our hospital, both 63 and 55-year-old women with typical precordial pressure pain, the first triggering psychological stress and the second physical, with electrocardiographic changes consistent with anterior infarction and cardiogenic shock, which were found in the coronary angiographic study observed normal coronary arteries and ventriculography determined apical ballooning of the left ventricle characteristic of the syndrome, with subsequent recovery and favorable clinical evolution at 6 months.

Incidence and definition of takotsubo syndrome

ESC CardioMed ◽  
2018 ◽  
pp. 1278-1280
Author(s):  
Abhiram Prasad
Keyword(s):  
Heart Failure ◽  
Acute Coronary Syndrome ◽  
Diagnostic Criteria ◽  
Apical Ballooning ◽  
Stress Cardiomyopathy ◽  
Apical Ballooning Syndrome ◽  
Takotsubo Syndrome ◽  
Coronary Syndrome ◽  
Definition Of ◽  
European Society Of Cardiology

Takotsubo syndrome (TTS) is also commonly known as apical ballooning syndrome and stress cardiomyopathy. The incidence of TTS has consistently been estimated to be close to 2% of all patients presenting with an initial diagnosis of an acute coronary syndrome, and perhaps as high as about 5% of women. TTS is a diagnosis of exclusion and in the absence of a diagnostic test, there is the need for diagnostic criteria. The Mayo Clinic diagnostic criteria are the most widely cited. The Heart Failure Association of the European Society of Cardiology published the most recent criteria in 2015.

Incidence and definition of takotsubo syndrome

ESC CardioMed ◽  
2018 ◽  
pp. 1278-1280
Author(s):  
Abhiram Prasad
Keyword(s):  
Heart Failure ◽  
Acute Coronary Syndrome ◽  
Diagnostic Criteria ◽  
Apical Ballooning ◽  
Stress Cardiomyopathy ◽  
Apical Ballooning Syndrome ◽  
Takotsubo Syndrome ◽  
Coronary Syndrome ◽  
Definition Of ◽  
European Society Of Cardiology

Takotsubo syndrome (TTS) is also commonly known as apical ballooning syndrome and stress cardiomyopathy. The incidence of TTS has consistently been estimated to be close to 2% of all patients presenting with an initial diagnosis of an acute coronary syndrome, and perhaps as high as about 5% of women. TTS is a diagnosis of exclusion and in the absence of a diagnostic test, there is the need for diagnostic criteria. The Mayo Clinic diagnostic criteria are the most widely cited. The Heart Failure Association of the European Society of Cardiology published criteria in 2015. An update to this chapter includes the most recent criteria from 2018.

scholarly journals Takotsubo syndrome in elderly woman: The diagnosis by transthoracic echocardiography

2019 ◽  
Vol 7 ◽  
pp. 2050313X1987892
Author(s):  
Inggita Hanung Sulistya ◽  
Anggoro Budi Hartopo ◽  
Lucia Kris Dinarti ◽  
Budi Yuli Setianto
Keyword(s):  
Acute Coronary Syndrome ◽  
Left Ventricle ◽  
Transthoracic Echocardiography ◽  
Troponin I ◽  
Acute Chest Pain ◽  
Apical Ballooning ◽  
Transient Condition ◽  
Takotsubo Syndrome ◽  
Coronary Syndrome ◽  
Concentric Hypertrophy

Takotsubo syndrome has increasingly been recognized in the differential diagnosis of patients presenting with acute chest pain. Those affected are typically older women suffering after an emotional or physical stress. Normally it is a transient condition but complications including death have been reported. We reported a case of takotsubo syndrome who was initially diagnosed as acute coronary syndrome. The patient presented with typical angina, ST-T segment changes, and elevated high sensitive–troponin I. Coronary angiography showed normal coronary arteries. Transthoracic echocardiography revealed mild left atrial dilatation and left ventricle concentric hypertrophy, reduced left ventricle ejection fraction with circumferential hypokinetic, apical ballooning, systolic anterior motion, left ventricle outflow tract obstruction, and sigmoid septum hypertrophy. One month later, patient recovered and transthoracic echocardiography revealed improved heart anatomy and function. To differentiate takotsubo syndrome with other conditions, especially acute coronary syndrome, is crucial. Their clinical presentations are similar but the managements are different. The transthoracic echocardiography holds an important role in supporting the diagnosis of takotsubo syndrome.

scholarly journals P256 Takotsubo syndrome early after treatment due to non cardiotoxic chemotheraphy agents

2020 ◽  
Vol 21 (Supplement_1) ◽  
Author(s):  
B Ozbay ◽  
E Gurses ◽  
H Kemal ◽  
E Simsek ◽  
H Kultursay
Keyword(s):  
Coronary Angiography ◽  
Left Ventricle ◽  
Troponin T ◽  
Epigastric Pain ◽  
Apical Ballooning ◽  
Prior History ◽  
Takotsubo Syndrome ◽  
Coronary Syndrome ◽  
T Wave ◽  
Wave Inversion

Abstract Physicians have encountered cardiotoxicity in different situations. The most known scenario is heart failure after especially anthracycline treatment. In this case, immediately after chemotherapy typical Takotsubo syndrome developed and was diagnosed with normal coronary angiography with apical ballooning movement in ventriculography. Acute cardiotoxicity may depend on different pathogenesis than ordinary toxicity mechanism. Case report A 65 years old female attended emergency department with epigastric pain after chemotherapy. She had vinorelbine and gemcitabine treatment for malignant urotelial renal carcinoma. The patient was consulted with cardiology department, because of progressive high troponin T levels. She had no prior history except urotelial carsinoma for one year and hypertension for seven years. Her prior chemotherapy protocols included carboplatine and docetaxel. She did not describe typical angina pectoris or shortness of breath. Electrocardiography (ECG) at admission had symmetrical T wave inversion on precordial derivations (figure 1). Echocardiography (echo) showed typical apical ballooning of the left ventricle (figure 2 and 3). We do not know the patient’s prior cardiac performance and acute coronary syndrome and Takotsubo syndrome were our preliminary diagnosis. Normal coronary arteries were seen on coronary angiography, ventriculography revealed apical ballooning movement of the left ventricle (Figure 4) and this supported our diagnosis as Takotsubo syndrome. She was already on valsartane 160 mg daily for hypertension and we included metoprolol 50 mg daily and enoxoparine 6000 IU s.c twice a day. For several days deep symmetrical T wave inversion persisted on ECG. After third day her ECG changings resolved (Figure 5) and echo images had recovered. The patient was discharged uneventfully and is followed. Abstract P256 figures

scholarly journals TAKOTSUBO SYNDROME INDUCED BY MALIGNANT PHEOCHROMOCYTOMA IN A PATIENT WITH TYPE 2 PAPILLARY RENAL CELL CARCINOMA – A CASE REPORT

2018 ◽  
Vol 91 (2) ◽  
pp. 242-244 ◽  
Author(s):  
Anca Diana Demea ◽  
Dan-Grigore Dunca ◽  
Roxana Adina Radu ◽  
Lucia Agoșton-Coldea
Keyword(s):  
Renal Cell Carcinoma ◽  
Cell Carcinoma ◽  
Renal Cell ◽  
Papillary Renal Cell Carcinoma ◽  
Apical Ballooning ◽  
Takotsubo Syndrome ◽  
Coronary Syndrome ◽  
Enzyme Elevation ◽  
Atherosclerotic Changes

The clinical presentation of the Takotsubo syndrome mimics an acute coronary syndrome with chest pain, ischemia-like ECG changes, mild to moderate myocardial enzyme elevation, and apical ballooning on echocardiography and ventriculography. On coronary angiography, epicardial coronary arteries are either normal or exhibit minimal atherosclerotic changes. Primary Takotsubo syndrome usually occurs in postmenopausal women in whom symptoms are triggered by emotional or physical stress, associated with catecholamine surges. Secondary Takotsubo syndrome may have multiple causes, including an increased catecholamine release due to pheochromocytoma.We present the case of a 56-years-old woman with confirmed Takotsubo syndrome who was later diagnosed with pheochromocytoma and type 2 papillary renal cell carcinoma.

scholarly journals Management of Takotsubo cardiomyopathy before non-cardiac surgery: A case report

2021 ◽  
Vol 29 (2) ◽  
pp. 271-274
Author(s):  
Tayfun Gürol
Keyword(s):  
Acute Coronary Syndrome ◽  
Takotsubo Cardiomyopathy ◽  
Orthopedic Surgery ◽  
Systolic Dysfunction ◽  
Apical Ballooning ◽  
Left Ventricular ◽  
Enzyme Release ◽  
Coronary Syndrome ◽  
Electrocardiographic Changes ◽  
Apical Balloon Syndrome

Takotsubo cardiomyopathy (left ventricular apical balloon syndrome) is characterized by transient apical ballooning, leading to apical systolic dysfunction. This syndrome typically mimics acute coronary syndrome in terms of electrocardiographic changes and cardiac enzyme release. Although its exact pathophysiology is still unclear, it is thought to be due to stress related to the catecholaminergic discharge. It is usually seen on postmenopausal women. Herein, we report a 78-year-old female patient with Takotsubo cardiomyopathy admitted to the orthopedic surgery clinic due to a femoral fracture and had no complication after surgery.

scholarly journals Acute Heart Failure in Apical Ballooning Syndrome (TakoTsubo/Stress Cardiomyopathy)

2011 ◽  
Vol 57 (12) ◽  
pp. 1400-1401 ◽  
Author(s):  
Malini Madhavan ◽  
Charanjit S. Rihal ◽  
Amir Lerman ◽  
Abhiram Prasad
Keyword(s):  
Heart Failure ◽  
Acute Heart Failure ◽  
Apical Ballooning ◽  
Stress Cardiomyopathy ◽  
Apical Ballooning Syndrome

scholarly journals Frequently Recurrent Takotsubo Syndrome in COPD

2019 ◽  
Vol 2019 ◽  
pp. 1-9
Author(s):  
Juan Vaz ◽  
Rikard Berggren ◽  
Berne Eriksson
Keyword(s):  
Ventricular Dysfunction ◽  
Apical Ballooning ◽  
Left Ventricular ◽  
Chronic Obstructive ◽  
Acute Dyspnea ◽  
Copd Exacerbation ◽  
Takotsubo Syndrome ◽  
Unique Case ◽  
Obstructive Pulmonary Disease ◽  
Coronary Syndrome

Cardiovascular disease is common among patients with chronic obstructive pulmonary disease (COPD). Takotsubo syndrome (TTS) is a transient cardiac disorder that, in its typical form, involves left ventricular dysfunction with apical ballooning and mimics acute coronary syndrome (ACS). “Bronchogenic TTS” has been proposed as a specific form of TTS (during severe acute dyspnea in asthma or COPD) with atypical presentation. Recurrent TTS in COPD seems to be exceptionally rare since only a handful of clinical cases have previously been reported in the literature. Here, we present a unique case of a frequently recurrent TTS during COPD exacerbation in a 70-year-old woman, with at least 4 different episodes of TTS within 5 years. This case report exemplifies the difficulties of the diagnosis of TTS at the onset of acute COPD exacerbation. Potential pathophysiological mechanisms and therapeutic strategies are also briefly discussed.

Takotsubo syndrome: A theoretical review over a clinical case

2011 ◽  
Vol 26 (S2) ◽  
pp. 401-401
Author(s):  
F. Silva-Carvalho ◽  
A. Moutinho
Keyword(s):  
Intracellular Signaling ◽  
Clinical Case ◽  
Troponin I ◽  
Apical Ballooning ◽  
Basal Region ◽  
Takotsubo Syndrome ◽  
Coronary Syndrome ◽  
Gi Protein ◽  
Coronary Syndromes ◽  
Psychological Stressor

The clinical case serves as an introductory note to the description of the Takotsubo Syndrome.The Takotsubo Syndrome has gained recent notoriety. It is estimated that this diagnosis is made in 2% of acute coronary syndromes. In up to 75% of the cases, a psychological stressor can be found, usually traumatic, and 25–40% of the patients meet the diagnostic criteria for depressive or anxious pathologies. It presents as an acute coronary syndrome, with pre-cordial pain and dyspnea, and in 90% of the cases there is elevated Troponin I, in average 0.49 ng/mL. There is mild ST-wave elevation and T-wave invertion, mostly on V2 and V3. The ventriculography presents the typical image, with apical ballooning and hypokinesia, that reverse in 20 days, average.The ratio of ß1 and ß2 receptors in the human heart is 4:1, and norepineprhin acts mostly in the former. It is released by the sympathetic terminals in the heart, which are 40% more dense in the basal region. Thus, the catecholaminergic action at the apex is mostly performed by circulating epinephrine, via ß2 receptors. The phenomena that occurs at supra-physiologic levels of epinephrine is called “stimulus trafficking” and results in a net change of intracellular signaling from Gs protein to Gi protein. The effect exists to protect against apoptosis in such conditions, but results in negative inotropism, most evident at the apex, where ß2 receptors are most prevalent.At last, this poster points some pathophysiologic factors in common between anxious pathologies and Takotsubo syndrome.

scholarly journals What is Takotsubo (Stress) Cardiomyopathy?

2015 ◽  
Vol 10 (1) ◽  
pp. 6 ◽  
Author(s):  
Abhiram Prasad ◽  
Keyword(s):  
Systolic Dysfunction ◽  
Apical Ballooning ◽  
Good Prognosis ◽  
Stress Cardiomyopathy ◽  
Apical Ballooning Syndrome ◽  
Presenting Symptoms ◽  
Coronary Syndrome ◽  
Cardiac Syndrome ◽  
Female Predominance ◽  
Post Menopausal

Takotsubo/stress cardiomyopathy (TC) or apical ballooning syndrome is an increasingly recognised entity around the world. It is an acute reversible cardiac syndrome that has a striking female predominance, with approximately 90 % of cases occurring in women, the vast majority of whom are post-menopausal. Chest pain and dysponea are the most common presenting symptoms. The symptoms and signs are similar to those in other acute cardiac conditions characterised by acute myocardial ischemia or heart failure. A characteristic feature of the syndrome is its relationship to emotional or physical stressful triggers. The process of diagnosing TC is, to a large extent, one of exclusion of other conditions that it mimics. The Mayo Clinic diagnostic criteria are the most widely used. Since acute coronary syndrome is often suspected before the diagnosis of TC is made, initial treatment is often similar to that for an acute myocardial infarction. However, after the diagnosis of TC is confirmed, treatment is supportive with monitoring and treatment of complications. The vast majority of patients with TC have good prognosis with complete resolution of systolic dysfunction.

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