Tako-Tsubo Cardiomyopathy
Takotsubo cardiomyopathy, also known as transient apical
ballooning syndrome,[1]
apical ballooning cardiomyopathy,[2]
stress-induced cardiomyopathy, broken-heart-syndrome, Gebrochenes-Herz-Syndrome,
and simply stress cardiomyopathy, is a type of non-ischemiccardiomyopathy in which there is a sudden
temporary weakening of the myocardium (the muscle of the heart). Because
this weakening can be triggered by emotional stress, such as the death
of a loved one, a break-up, or constant rejection, the condition is also
known as broken heart syndrome.[3]
Stress cardiomyopathy is a well-recognized cause of acute heart
failure, lethal ventricular arrhythmias, and ventricular rupture.[4]
The typical presentation of someone with takotsubo cardiomyopathy is a
sudden onset of congestive heart
failure or chest pain associated with ECG changes suggestive
of an anterior wallmyocardial infarction. During the
course of evaluation of the patient, a bulging out of the left
ventricular apex with a hypercontractile base of the left ventricle is
often noted. It is the hallmark bulging out of the apex of the heart
with preserved function of the base that earned the syndrome its name
"tako tsubo", or octopus trap
in Japan,
where it was first described.[5]
The cause appears to involve high circulating levels of catecholamines
(mainly adrenaline/epinephrine).
Evaluation of individuals with takotsubo cardiomyopathy typically
includes a coronary angiogram,
which will not reveal any significant blockages that would cause the left ventricular dysfunction. Provided that the
individual survives their initial presentation, the left ventricular
function improves within 2 months. Takotsubo cardiomyopathy is more
commonly seen in post-menopausal women.[6]
Often there is a history of a recent severe emotional or physical
stress. [6]
+ نوشته شده در ۱۳۸۹/۰۶/۱۲ ساعت 23:44 توسط
|
EMERGENCY MEDICINE SPECIALIST
