Differentiation between patients with takotsubo cardiomyopathy and those with anterior acute myocardial infarction.
BACKGROUND
There has not been a comparison of the electrocardiographic (ECG) finding of ST-segment elevation in the precordial leads in patients with takotsubo cardiomyopathy (TC) and those with anterior acute myocardial infarction (AMI), with regard to the location of the culprit lesion.


RESULTS
The present study evaluated 18 patients with TC, and 85 with anterior AMI who were divided into 3 groups: group A had the culprit lesion proximal to both the first septal branch (S1) and the first diagonal branch (D1), group B had the culprit lesion proximal to either S1 or D1, and group C had the culprit lesion distal to both S1 and D1. In patients with TC, reciprocal ST-segment depression in the inferior leads was observed less frequently than in patients in groups A (p<0.0001) and B (p=0.0002), and abnormal Q waves and ST-segment elevation in the inferior leads were observed more frequently than in group A (p=0.0007, p=0.0057, respectively). The ECG findings in TC did not differ from those in group C.


CONCLUSIONS
Electrocardiographic findings may differentiate TC from AMI with a proximal lesion of left anterior descending coronary artery, but not those with distal lesions.
Inoue
Masaru
M
Molecular Genetics of Cardiovascular Disorders, Division of Cardiovascular Medicine, Graduate School of Medical Science, Kanazawa University, Kanazawa, Japan.
Shimizu
Masami
M
Ino
Hidekazu
H
Yamaguchi
Masato
M
Terai
Hidenobu
H
Fujino
Noboru
N
Sakata
Kenji
K
Funada
Akira
A
Tatami
Ryozo
R
Ishise
Syozo
S
Kanaya
Hounin
H
Mabuchi
Hiroshi
H
D000368:Aged; D009202:Cardiomyopathies / Q000175:diagnosis*; D002637:Chest Pain / Q000453:epidemiology; D017023:Coronary Angiography; D003402:Creatine Kinase / Q000097:blood; D003937:Diagnosis, Differential; D004562:Electrocardiography; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000175:diagnosis*; D012189:Retrospective Studies; D012907:Smoking / Q000453:epidemiology
D003402:Creatine Kinase