Clinical characteristics, demographics and prognosis of transient left ventricular apical ballooning syndrome.
BACKGROUND
Transient left ventricular apical ballooning syndrome also called Tako-Tsubo cardiomyopathy is defined as a syndrome consisting of stress induced apical ballooning of the left ventricle and normal coronary arteries. The majority of the published reports are case reports or case series with a small number of patients. The goal of this study was to perform statistical analysis of reported cases and case series in the literature in order to study demographic, clinical characteristics and prognosis of this syndrome.


METHODS
A PubMed search of the terms transient left ventricular apical ballooning, Tako-Tsubo, takotsubo, and apical cardiomyopathy was conducted for this study. All reports that contained information about individual patients were included in the statistical analysis.


RESULTS
The majority of the patients were women (93.5%). Asians were the largest group (57.2%) followed by Caucasians (40%). The presentations mimics an acute myocardial infarction. The most frequent presenting symptom was chest pain (65.9%) followed by dyspnea (16.2%). ST elevation was the most common ECG abnormality (87.5%). Contrary to most reports, this is not a benign disease with complications occurring in 18.9% and death in 3.2%. The most common complication was shock followed by left ventricular thrombus formation and congestive heart failure.


CONCLUSIONS
Apical ballooning syndrome occurs most commonly in women and is associated with high complication rate. There are significant differences in presenting symptoms between race and gender which warrant further investigation.
Department of Medicine, Division of Cardiology, University of California, Irvine Medical Center, CA 92868, USA.
Daniel
D
Donohue
Mohammad-Reza
MR
Movahed
D000368:Aged; D044466:Asian People / Q000706:statistics & numerical data; D015415:Biomarkers / Q000097:blood; D009202:Cardiomyopathies / Q000150:complications / Q000175:diagnosis* / Q000453:epidemiology* / Q000208:ethnology / Q000473:pathology; D003328:Coronary Thrombosis / Q000209:etiology; D003402:Creatine Kinase / Q000097:blood; D004562:Electrocardiography; D005260:Female; D006329:Heart Conduction System / Q000473:pathology; D006333:Heart Failure / Q000209:etiology; D006352:Heart Ventricles / Q000473:pathology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D017678:Sex Distribution; D012770:Shock, Cardiogenic / Q000209:etiology; D013577:Syndrome; D014336:Troponin / Q000097:blood; D044465:White People / Q000706:statistics & numerical data
D015415:Biomarkers; D014336:Troponin; D003402:Creatine Kinase