title: Left ventricular thrombus formation and cardioembolic complications in patients with Takotsubo-like syndrome: a systematic review.
abstract: BACKGROUND
  Though a severe left ventricular systolic dysfunction has been described in most patients with Takotsubo-like (or Apical Ballooning) syndrome, the occurrence of intra-cavitary thrombus formation seems to be such an exceptional finding. However, no large studies but single case descriptions of this complication are available over the last decade in the literature.
  
  
  METHODS
  By searching for the PubMed-Medline database we selected 14 studies that met our eligibility criteria.
  
  
  RESULTS
  Demographic, clinical and morphofunctional characteristics of 15 patients who where described to have left ventricular thrombosis as a complication of the Takotsubo-like syndrome are comprehensively described in this review. Cardioembolic complications (stroke in 3 cases, renal infarction or popliteal artery thrombosis in other two) occurred in 33.3% out of them. The incidence of thrombus formation and related systemic embolisms in the general population with this syndrome were established on the basis of such available historical data and reviews on this subject.
  
  
  CONCLUSIONS
  Left ventricular thrombus formation has been reported in at least 14 studies (15 patients) over the last decade until the end of 2007. This approximately results in about 2.5% of all the patients with documented Takotsubo-like syndrome. Cardioembolic complications occurred in 5/15 cases, corresponding to 0.8% of the whole known population.
authors.affiliation: Clinical and Experimental Department of Medicine and Pharmacology, Cardiology Unit, University Hospital of Messina, Messina, Italy. cesaredegregorio@tiscali.it
authors.forename: Cesare
authors.initials: C
authors.lastname: de Gregorio
authors.forename: Patrizia
authors.initials: P
authors.lastname: Grimaldi
authors.forename: Concetta
authors.initials: C
authors.lastname: Lentini
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D013577:Syndrome; D054549:Takotsubo Cardiomyopathy / Q000150:complications / Q000175:diagnosis / Q000503:physiopathology*; D013923:Thromboembolism / Q000150:complications / Q000175:diagnosis / Q000503:physiopathology*; D018487:Ventricular Dysfunction, Left / Q000150:complications / Q000175:diagnosis / Q000503:physiopathology*