title: Clinical characteristics of tako-tsubo cardiomyopathy.
abstract: Tako-tsubo cardiomyopathy (TTC) is increasingly diagnosed in the United States, especially in the Caucasian population. To evaluate the clinical features and outcome of patients with TTC, we evaluated 34 patients (32 women and 2 men) 22 to 88 years of age (mean 66 +/- 14) who fulfilled the following criteria: (1) akinesia or dyskinesia of the apical and/or midventricular segments of the left ventricle with regional wall motion abnormalities that extended beyond the distribution of a single epicardial vessel and (2) absence of obstructive coronary artery disease. Twenty-five patients (74%) presented with chest pain, 20 patients (59%) presented with dyspnea, and 8 patients (24%) presented with cardiogenic shock. Twenty-two patients (65%) had ST-segment elevation and 14 patients (41%) had T-wave inversion on presentation. Twenty-five patients (74%) reported a preceding stressful event. Cardiac biomarkers were often mildly increased, with a mean troponin I (peak) of 13.9 +/- 24. Mean +/- SD left ventricular ejection fractions were 28 +/- 10% at time of presentation and 51 +/- 14 at time of follow-up (p <0.0001). Two patients (6%) died during the hospital stay. Average duration of hospital stay was 6.6 +/- 6.2 days. In conclusion, TTC is common in postmenopausal women with preceding physical or emotional stress. It predominantly involves the apical portion of the left ventricle and patients with this condition have a favorable outcome with appropriate medical management. The precise cause remains unclear.
authors: Division of Internal Medicine, Lahey Clinic Medical Center, Burlington, Massachusetts, USA. Venki.Vidi@gmail.com
authors: Venkatesan
authors: V
authors: Vidi
authors: Vinutha
authors: V
authors: Rajesh
authors: Premranjan P
authors: PP
authors: Singh
authors: Jayanta T
authors: JT
authors: Mukherjee
authors: Rodrigo M
authors: RM
authors: Lago
authors: David M
authors: DM
authors: Venesy
authors: Sergio
authors: S
authors: Waxman
authors: Christopher T
authors: CT
authors: Pyne
authors: Thomas C
authors: TC
authors: Piemonte
authors: David E
authors: DE
authors: Gossman
authors: Richard W
authors: RW
authors: Nesto
mesh_terms: D054058:Acute Coronary Syndrome / Q000209:etiology; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D004562:Electrocardiography; D005260:Female; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012770:Shock, Cardiogenic / Q000209:etiology; D013318:Stroke Volume; D054549:Takotsubo Cardiomyopathy / Q000150:complications* / Q000175:diagnosis* / Q000628:therapy; D016896:Treatment Outcome; D055815:Young Adult