title: Clinical characteristics of takotsubo cardiomyopathy in north america.
abstract: BACKGROUND
  Takotsubo cardiomyopathy (TC) or transient left ventricular apical ballooning syndrome is an acute cardiac syndrome characterized by transient wall motion abnormalities extending beyond a single epicardial vessel in the absence of significant obstructive coronary artery disease.
  
  
  OBJECTIVE
  This study was to describe the clinical characteristics of TC in North America.
  
  
  METHODS
  We identified 10 patients who met the Mayo Clinic criteria for TC using our Electronic Medical Records. We also conducted a systematic review of case series of TC that were done in North America by searching the MEDLINE database. We identified 11 case series that met our eligibility criteria.
  
  
  RESULTS
  Our systematic review included 620 patients. Chest pain and ST segment elevation were the cardinal features of this syndrome, but the prevalence was lower than in the European and Asian cohort (50% and 39% as compared with 80% and 70%, respectively). Classic precipitating emotional or physical stress was described in > 80% of patients. Cardiac biomarkers were found to be elevated in >90% of our patients.
  
  
  CONCLUSIONS
  TC is a worldwide problem and clinical presentation appears to be similar in North American, European, and Asian countries. However, fewer patients in our cohort presented with typical chest pain and electrocardiography (ECG) changes, which might suggest ethnic variations in the syndrome or perhaps a more aggressive diagnostic approach in North American countries.
authors: Department of Internal Medicine, Bassett Medical Center and Columbia University College of Physicians and Surgeons, Cooperstown, New York, USA.
authors: Saeed
authors: S
authors: Ahmed
authors: Patompong
authors: P
authors: Ungprasert
authors: Supawat
authors: S
authors: Ratanapo
authors: Tanveer
authors: T
authors: Hussain
authors: Erik P
authors: EP
authors: Riesenfeld
keywords: Broken heart syndrome; Left ventricular apical ballooning syndrome; Stress induced cardiomyopathy; Takotsubo cardiomyopathy; Transient left ventricular dysfunction
references: J Invasive Cardiol. 2009 May;21(5):216-22
references: 19411722
references: J Am Coll Cardiol. 2003 Mar 5;41(5):737-42
references: 12628715
references: Clinics (Sao Paulo). 2011;66(11):1895-9
references: 22086519
references: Heart Lung Circ. 2010 Oct;19(10):601-5
references: 20655278
references: Jpn Circ J. 2000 Feb;64(2):156-9
references: 10716533
references: J Hosp Med. 2009 Mar;4(3):200-2
references: 19301382
references: J Am Coll Cardiol. 2010 Jan 26;55(4):333-41
references: 20117439
references: Chest. 2007 Sep;132(3):809-16
references: 17573507
references: Int J Cardiol. 2009 May 15;134(2):273-7
references: 18406480
references: Am J Cardiol. 2009 Aug 15;104(4):578-82
references: 19660615
references: Circulation. 2005 Feb 1;111(4):472-9
references: 15687136
references: Int J Cardiol. 2010 Jun 11;141(3):297-303
references: 19155079
references: N Engl J Med. 2005 Feb 10;352(6):539-48
references: 15703419
references: Clin Cardiol. 2007 Jan;30(1):14-8
references: 17262772
references: Heart. 2003 Sep;89(9):1027-31
references: 12923018
references: Am J Cardiol. 2004 Aug 1;94(3):343-6
references: 15276100
references: Int J Cardiol. 2008 Mar 14;124(3):283-92
references: 17651841
references: Am Heart J. 2006 Sep;152(3):469.e9-13
references: 16923415
references: Am Heart J. 2009 May;157(5):933-8
references: 19376324
references: J Cardiol. 1991;21(2):203-14
references: 1841907
references: Ann Intern Med. 2004 Dec 7;141(11):858-65
references: 15583228
references: Am J Cardiol. 2009 Apr 1;103(7):1015-9
references: 19327433
references: J Am Coll Cardiol. 2001 Jul;38(1):11-8
references: 11451258
references: Am J Emerg Med. 2009 Feb;27(2):220-6
references: 19371532
references: Am Heart J. 2002 Mar;143(3):448-55
references: 11868050
references: Rev Cardiovasc Med. 2007 Fall;8(4):228-33
references: 18192946
references: Eur Heart J. 2006 Jul;27(13):1523-9
references: 16720686
references: Am Heart J. 2008 Mar;155(3):408-17
references: 18294473