[Tako-tsubo cardiomyopathy. Incidence in patients with acute coronary syndrome].
METHODS
In 2005, an emergency coronary angiography was performed at the authors' clinic in 215 patients (148 men, 67 women) with troponin-positive acute coronary syndrome.


RESULTS
In five of these patients (exclusively women, mean age [+/- SD] 61 +/- 12 years), tako-tsubo cardiomyopathy was identified. This represents a frequency of 2.3% (5/215 patients) of all investigated patients and of 7.5% (5/67 patients) within the group of women. In these patients, levocardiography revealed severe left ventricular dysfunction with apical wall motion abnormality known as "apical ballooning". At angiography, a significant coronary artery disease could be excluded. Chest pain was present in all patients, combined with ST segment elevation in one (20%) and T-wave inversion in four (80%). Elevated cardiac markers were found in all cases. All patients experienced psychologically stressful circumstances preceding the onset of symptoms. The patients all survived, showing normalized ejection fraction and rapid restoration of previous cardiovascular function within a mean (+/- SD) of 15 +/- 11 days.


CONCLUSIONS
Tako-tsubo cardiomyopathy is a distinctive form of regional left ventricular dysfunction triggered by psychologically stressful events, which has a favorable clinical outcome. With a remarkable frequency of 7.5% especially in women, tako-tsubo cardiomyopathy should be included in the differential diagnosis of acute myocardial infarction.
Wedekind
Horst
H
St. Bernward Krankenhaus, Hildesheim.
Möller
Karsten
K
Scholz
Karl Heinrich
KH
D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D002637:Chest Pain / Q000209:etiology; D017023:Coronary Angiography; D003937:Diagnosis, Differential; D004452:Echocardiography; D004562:Electrocardiography; D004630:Emergencies; D005260:Female; D005500:Follow-Up Studies; D006334:Heart Function Tests; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000175:diagnosis; D012737:Sex Factors; D013315:Stress, Psychological / Q000150:complications*; D013318:Stroke Volume; D013997:Time Factors; D014336:Troponin / Q000097:blood; D018487:Ventricular Dysfunction, Left / Q000097:blood / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000209:etiology
D014336:Troponin