Tako-tsubo cardiomyopathy: insights from a community hospital.
OBJECTIVE
To describe the actual incidence, prevalence among acute coronary syndrome patients and rate of recurrences of tako-tsubo cardiomyopathy in an emergency department of a community hospital.


METHODS
We report the in-hospital and long-term clinical course (7.5 years follow-up) of 25 consecutive tako-tsubo cardiomyopathy patients (mean age 66.8 ± 11.76 years; F/M: 21/4) admitted to a community hospital (referring population: 97,000 inhabitants).


RESULTS
The incidence rate of tako-tsubo cardiomyopathy was 0.03 cases per 1000 person-years; the prevalence was 3.0% among those with acute coronary syndrome and 7.6% among ST elevation myocardial infarction patients. Clinical presentations included mainly chest pain (n = 16, 64%) and dyspnea (n = 3, 12%). Precipitating conditions were emotional (n = 10, 40%), physical stress (n = 5, 20%) or both (n = 1, 4%); no stressors were recorded in nine patients (36%). Two patients died during hospitalization (8%). At the end of follow-up (mean time: 960.24 ± 724.34 days), all patients (n = 23) were alive and no major cardiovascular events were observed. Five patients had recurrences (22%). The mean time of recurrence was 105.4 ± 82.92 days and the clinical presentation was less severe compared with the first event: ECG had less ST involvement, ejection fraction was higher and cardiac injury biomarkers were lower.


CONCLUSIONS
In our population incidence and prevalence of tako-tsubo cardiomyopathy among acute coronary syndrome patients, as well as the recurrence rate of tako-tsubo cardiomyopathy, were higher than previously reported, suggesting that probably this syndrome often passes undiagnosed.
Deparment of Emergency and Cardiology, Ospedale San Antonio, San Daniele del Friuli, Udine, Italy. olgavriz@yahoo.com
Olga
O
Vriz
Caterina
C
Driussi
Maria G
MG
Fazio
Franco
F
Arteni
Lucio
L
Mos
Franco
F
Pertoldi
Manola
M
Bettio
Daniela
D
Pavan
Eduardo
E
Bossone
D054058:Acute Coronary Syndrome / Q000150:complications / Q000453:epidemiology; D000368:Aged; D004562:Electrocardiography / Q000379:methods; D004636:Emergency Service, Hospital; D005260:Female; D005500:Follow-Up Studies; D006760:Hospitalization; D006764:Hospitals, Community; D006801:Humans; D015994:Incidence; D007558:Italy / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000150:complications / Q000453:epidemiology; D015995:Prevalence; D011379:Prognosis; D012008:Recurrence; D054549:Takotsubo Cardiomyopathy / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology* / Q000209:etiology