title: Epidemiology and clinical profile of Takotsubo cardiomyopathy.
abstract: First described in Japan over 2 decades ago, takotsubo cardiomyopathy (TTC) has emerged as a unique cardiomyopathy with world-wide recognition, mimicking acute coronary syndrome. In early TTC experience, typical patients were older women, with a triggering emotional event, ST-segment elevation, and apical ballooning left ventricular (LV) contraction pattern. However, TTC is now more heterogeneous, occurring in males and younger individuals, without ST-segment elevation, as a spontaneous event in the absence of a trigger, and with diverse LV contraction patterns. Furthermore, TTC is more common than initially thought, now constituting 10% of women with suspected acute coronary syndrome. TTC is also associated with a broader range of psychological or physical triggers, including presentation during outpatient medical evaluations or hospitalization for acute illness. Although TTC has been considered a benign condition, it now carries a small but important risk for adverse outcomes, including cardiac arrest in 5%. Hemodynamic instability requiring intervention with vasopressor drugs or intra-aortic balloon pump is necessary in 15% and in-hospital mortality is approximately 5%, largely because of refractory cardiogenic shock or irreversible major comorbid conditions. Although complete cardiac recovery usually occurs rapidly, post-hospital survival may be less than the general population of similar age, largely because of concomitant illnesses. TTC may reoccur in up to 10% of patients, but β-blocking drugs are not absolutely preventive for initial or subsequent events.
authors.affiliation: Minneapolis Heart Institute Foundation at Abbott Northwestern Hospital.
authors.forename: Scott W
authors.initials: SW
authors.lastname: Sharkey
authors.forename: Barry J
authors.initials: BJ
authors.lastname: Maron
mesh_terms: D054058:Acute Coronary Syndrome / Q000188:drug therapy / Q000473:pathology / Q000503:physiopathology; D000375:Aging / Q000473:pathology*; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D008297:Male; D009200:Myocardial Contraction; D012737:Sex Factors; D054549:Takotsubo Cardiomyopathy / Q000188:drug therapy / Q000401:mortality / Q000503:physiopathology; D014662:Vasoconstrictor Agents / Q000627:therapeutic use*
chemical_list: D014662:Vasoconstrictor Agents