title: Clinical presentation, treatment, and long-term outcomes in patients with takotsubo cardiomyopathy. Experience of a single cardiology center.
abstract: BACKGROUND
  Takotsubo cardiomyopathy (TTC) is a rare transient cardiomyopathy mimicking acute coronary syndrome (ACS).
  
  
  OBJECTIVE
  The aim of the study was to retrospectively analyze the clinical course, treatment strategies, and follow-up of patients with TTC.
  
  
  METHODS
  Among all patients hospitalized in the department between January 2005 and January 2010, we identified a group of patients who were fulfilling the modified Mayo Clinic criteria for the diagnosis of TTC. Clinical presentation, hospital course, and clinical outcomes were analyzed.
  
  
  RESULTS
  A total of 31 patients with TTC were included into the study; women comprised 93.5% of the study population. The most common symptoms included chest pain and dyspnea caused by emotional or physical stress. Cardiogenic shock was present in 2 subjects and life-threatening ventricular arrhythmias in 3 other patients. Twenty-four patients had ST-segment elevation on the electrocardiogram. A mean left ventricular ejection fraction was 42 +/-8.6% during contractility abnormalities, and it increased to 58 +/-7.9% during recovery. Troponin I was positive in 30 cases with a mean peak level of 2.7 +/-5.1 ng/ml. Follow-up data were available in 23 patients and a mean follow-up was 955 +/-502.8 days. We did not observe a recurrence of TTC.
  
  
  CONCLUSIONS
  TTC is observed mainly in postmenopausal women. Clinical presentation of TTC is almost indistinguishable from ACS, but its course is milder and the outcomes are better.
authors.affiliation: 1st Department of Cardiology, Medical University of Warsaw, Independent Public Central Clinical Hospital, Warszawa, Poland. grzegorz.opolski@wum.edu.pl
authors.forename: Grzegorz
authors.initials: G
authors.lastname: Opolski
authors.forename: Maciej M
authors.initials: MM
authors.lastname: Pawlak
authors.forename: Marek F
authors.initials: MF
authors.lastname: Roik
authors.forename: Janusz
authors.initials: J
authors.lastname: Kochanowski
authors.forename: Piotr
authors.initials: P
authors.lastname: Scisło
authors.forename: Radosław
authors.initials: R
authors.lastname: Piatkowski
authors.forename: Janusz
authors.initials: J
authors.lastname: Kochman
authors.forename: Grzegorz
authors.initials: G
authors.lastname: Karpiński
authors.forename: Robert
authors.initials: R
authors.lastname: Kowalik
authors.forename: Marcin
authors.initials: M
authors.lastname: Grabowski
authors.forename: Paweł
authors.initials: P
authors.lastname: Balsam
authors.forename: Krzysztof J
authors.initials: KJ
authors.lastname: Filipiak
mesh_terms: D054058:Acute Coronary Syndrome / Q000175:diagnosis; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015897:Comorbidity; D003920:Diabetes Mellitus / Q000453:epidemiology; D003937:Diagnosis, Differential; D004562:Electrocardiography; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006949:Hyperlipidemias / Q000453:epidemiology; D006973:Hypertension / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D029424:Pulmonary Disease, Chronic Obstructive / Q000453:epidemiology; D012042:Registries; D012189:Retrospective Studies; D012907:Smoking / Q000453:epidemiology; D054549:Takotsubo Cardiomyopathy / Q000175:diagnosis* / Q000188:drug therapy* / Q000453:epidemiology; D016896:Treatment Outcome