Tako-Tsubo-like cardiomyopathy: specific ECG findings, characterization and clinical findings in a European single center.
OBJECTIVE
A newly discovered heart syndrome mimicking acute coronary syndrome has been termed 'Tako-Tsubo cardiomyopathy' (TTC). Differentiation from acute myocardial infarction using the ECG is an important issue in clinical practice.


METHODS
We retrospectively analyzed patients admitted for cardiac catheterization between September 2003 and September 2006.


RESULTS
From 26,593 cardiac catheterization procedures, we identified 21 patients with suggested TTC (0.08%). Trigger mechanisms were present in 38.1%; all patients had elevated troponin levels (mean 3.9 ng/ml). Median age was 68.4 years; 90.5% were female. Hypertension was seen in 85.7% and atrial fibrillation in 19.1%. Specific ECG findings related to a TTC are: a mild elevation of the ST segment arising from the S curve of the QRS complex, where the maximum ST segment elevation at the basis of the T wave is <1.5 mm, T-wave inversion, absence of ST segment depression and a summated amplitude of the S curve in V1 plus R in V6 <1.5 mV. An intraventricular gradient was seen in 9.5%; coronary atherosclerosis was detected in 57.1%. Follow-Up Data: Mean follow-up was 13.2 months. 47.6% were free from angina or dyspnea, most of the patients received beta-blockers/ACE inhibitors (76.2%). One patient had a sudden cardiac death (4.8%), 1 patient became an implantable cardioverter-defibrillator primarily due to resuscitation.


CONCLUSIONS
TTC is a rare syndrome mimicking acute coronary syndrome that shows a specific ECG pattern and does not appear to be an unambiguously benign disease.
von Korn
Hubertus
H
Department of Cardiology, Krankenhaus Hetzelstift, Neustadt/Weinstrasse, Germany. h.vonkorn@new.marienhaus-gmbh.de
Yu
Jiangtao
J
Lotze
Ulrich
U
Ohlow
Marc-Alexander
MA
Huegl
Burkhard
B
Schulte
Walter
W
Haberl
Kai
K
Wagner
Andreas
A
Gruene
Stefan
S
Lauer
Bernward
B
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001706:Biopsy; D006328:Cardiac Catheterization; D004562:Electrocardiography; D005060:Europe; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D054549:Takotsubo Cardiomyopathy / Q000175:diagnosis*