Time course of electrocardiographic changes in patients with tako-tsubo syndrome: comparison with acute myocardial infarction with minimal enzymatic release.
BACKGROUND
The time course of the electrocardiographic (ECG) changes in patients with tako-tsubo syndrome remains unknown.


RESULTS
In the present study, 16 patients with tako-tsubo syndrome and 15 patients with anterior acute myocardial infarction with minimal enzymatic release (minimal AMI) were evaluated. Left ventricular dysfunction dramatically resolved approximately 2 weeks later in both groups. In the patients with tako-tsubo syndrome, the admission ECG usually showed ST segment elevation, especially in leads V(3-6). T wave inversion deepened progressively to its first negative peak, which occurred at approximately 3 days. The T wave was shallow for several days and then deepened again, the second negative peak occurring at approximately 2-3 weeks. The QT interval was prolonged as the T wave deepened, and shortened as the T wave became shallow. In the patients with minimal AMI, a similar time course of ECG changes was observed after reperfusion. In general, at 3 days or later during the early phase, T wave inversion was deeper and the QTc interval was longer in tako-tsubo syndrome than in minimal AMI.


CONCLUSIONS
Because the time course of the ECG changes, as well as that of the left ventricular dysfunction, is similar between tako-tsubo syndrome and minimal AMI, these 2 cardiac disorders must be carefully differentiated.
Kurisu
Satoshi
S
Department of Cardiology, Hiroshima City Hospital, Japan. skurisu@nifty.com
Inoue
Ichiro
I
Kawagoe
Takuji
T
Ishihara
Masaharu
M
Shimatani
Yuji
Y
Nakamura
Suji
S
Yoshida
Masashi
M
Mitsuba
Naoya
N
Hata
Takaki
T
Sato
Hikaru
H
D006328:Cardiac Catheterization; D009202:Cardiomyopathies / Q000503:physiopathology; D003402:Creatine Kinase / Q000097:blood; D004562:Electrocardiography; D006801:Humans; D009203:Myocardial Infarction / Q000503:physiopathology; D018579:Patient Selection; D013577:Syndrome; D013997:Time Factors; D018487:Ventricular Dysfunction, Left / Q000503:physiopathology*; D016277:Ventricular Function, Left
D003402:Creatine Kinase