title: Electrocardiogram changes and wall motion abnormalities in the acute phase of Tako-Tsubo syndrome.
abstract: BACKGROUND
  The Tako-Tsubo syndrome is still rarely diagnosed in patients presenting with symptoms of acute myocardial ischaemia. It is accompanied by wall motion abnormalities of the left ventricle but significant narrowings or occlusions of epicardial coronary arteries are absent. We investigated a potential relationship between electrocardiogram (ECG) changes, wall motion abnormalities and gender influence of Tako-Tsubo syndrome in an Austrian cohort of Tako-Tsubo syndrome patients.
  
  
  RESULTS
  We were recently able to describe four different anatomical types of Tako-Tsubo syndrome in 153 patients of the Austrian Tako-Tsubo syndrome registry. In the present retrospective analysis we investigated ischaemia-related changes in the first diagnostic ECG for the different types of Tako-Tsubo syndrome: the apical and the combined apical-midventricular type showed most frequently a ST elevation (41.1% and 35.3%), whereas the midventricular type of Tako-Tsubo syndrome was more often accompanied by T wave inversion (60%). ECG changes in relation to the Tako-Tsubo syndrome type were similar in women and men. There was no difference in the prevalence of clinical complications among patients presenting with ST elevation or left bundle branch block (14.5%) compared with patients without ST elevation (10.4%) (p=0.476).
  
  
  CONCLUSIONS
  Patients with Tako-Tsubo syndrome show characteristic ECG changes in the first diagnostic ECG which are associated to some extent with the anatomical type of Tako-Tsubo syndrome, but these ECG changes were not related to clinical outcome.
authors.affiliation: 3rd Department of Medicine, Cardiology and Intensive Care Medicine, Wilhelminenhospital, Vienna, Austria valerie.weihs@chello.at.
authors.forename: Valerie
authors.initials: V
authors.lastname: Weihs
authors.affiliation: Krankenhaus der Barmherzigen Schwestern, Linz, Austria.
authors.forename: Daniela
authors.initials: D
authors.lastname: Szücs
authors.affiliation: 3rd Department of Medicine, Cardiology and Intensive Care Medicine, Wilhelminenhospital, Vienna, Austria.
authors.forename: Barbara
authors.initials: B
authors.lastname: Fellner
authors.affiliation: Klinikum Kreuzschwestern, Wels, Austria.
authors.forename: Bernd
authors.initials: B
authors.lastname: Eber
authors.affiliation: LKH Graz West, Austria.
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Weihs
authors.affiliation: AKH Linz, Austria.
authors.forename: Thomas
authors.initials: T
authors.lastname: Lambert
authors.affiliation: Universitätsklinik für Inneren Medizin, Innsbruck, Austria.
authors.forename: Bernhard
authors.initials: B
authors.lastname: Metzler
authors.affiliation: Hanusch-Krankenhaus, Vienna, Austria.
authors.forename: Georg
authors.initials: G
authors.lastname: Titscher
authors.affiliation: Donauspital im SMZ-Ost, Vienna, Austria.
authors.forename: Beate
authors.initials: B
authors.lastname: Hochmayer
authors.affiliation: Kaiser-Franz-Josef-Spital, Vienna, Austria.
authors.forename: Cornelia
authors.initials: C
authors.lastname: Dechant
authors.affiliation: Krankenhaus der Elisabethinen Linz, Austria.
authors.forename: Veronika
authors.initials: V
authors.lastname: Eder
authors.affiliation: Krankenhaus der Barmherzigen Schwestern, Linz, Austria.
authors.forename: Peter
authors.initials: P
authors.lastname: Siostrzonek
authors.affiliation: AKH Linz, Austria.
authors.forename: Franz
authors.initials: F
authors.lastname: Leisch
authors.affiliation: Paracelsus Medizinische Privatuniversität, Salzburg, Austria.
authors.forename: Max
authors.initials: M
authors.lastname: Pichler
authors.affiliation: Universitätsklinik für Inneren Medizin, Innsbruck, Austria.
authors.forename: Otmar
authors.initials: O
authors.lastname: Pachinger
authors.affiliation: Hanusch-Krankenhaus, Vienna, Austria.
authors.forename: Georg
authors.initials: G
authors.lastname: Gaul
authors.affiliation: Donauspital im SMZ-Ost, Vienna, Austria.
authors.forename: Heinz
authors.initials: H
authors.lastname: Weber
authors.affiliation: Kaiser-Franz-Josef-Spital, Vienna, Austria.
authors.forename: Andrea
authors.initials: A
authors.lastname: Podczeck-Schweighofer
authors.affiliation: Krankenhaus der Elisabethinen Linz, Austria.
authors.forename: Hans-Joachim
authors.initials: HJ
authors.lastname: Nesser
authors.affiliation: 3rd Department of Medicine, Cardiology and Intensive Care Medicine, Wilhelminenhospital, Vienna, Austria.
authors.forename: Kurt
authors.initials: K
authors.lastname: Huber
mesh_terms: D003937:Diagnosis, Differential; D004452:Echocardiography; D004562:Electrocardiography; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009068:Movement / Q000502:physiology; D012189:Retrospective Studies; D000072657:ST Elevation Myocardial Infarction / Q000175:diagnosis; D012727:Sex Characteristics; D054549:Takotsubo Cardiomyopathy / Q000175:diagnosis / Q000503:physiopathology*; D018487:Ventricular Dysfunction, Left / Q000175:diagnosis / Q000503:physiopathology
keywords: Acute ECG changes; Tako-Tsubo syndrome; anatomical types