title: Broken heart as work-related accident: Occupational stress as a cause of takotsubo cardiomyopathy in 55-year-old female teacher - Role of automated function imaging in diagnostic workflow.
abstract: Takotsubo cardiomiopathy (TTC) (known also as "ampulla cardiomyopathy," "apical ballooning" or "broken heart syndrome") is connected with a temporary systolic left ventricular dysfunction without the culprit coronary lesion. Takotsubo cardiomyopathy was first described in 1990 in Japan after octopus trapping pot with a round bottom and narrow neck similar in shape to left ventriculogram in TTC patients. The occurrence of TTC is usually precipitated by a stressful event with a clinical presentation mimicking myocardial infarction: chest pain, ST-T segment elevation or T-wave inversion, a rise in cardiac troponin, and contractility abnormalities in echocardiography. A left ventricular dysfunction is transient and improves within a few weeks. Takotsubo cardiomyopathy typically occurs in postmenopausal women and the postulated mechanism is catecholamine overstimulation. Moreover, the distribution of contractility impairments usually does not correspond with typical region supplied by a single coronary artery. Therefore, the assessment of regional pattern of systolic dysfunction with speckle-tracking echocardiography and automated function imaging (AFI) technique may be important in diagnosis of TTC and may improve our insight into its patophysiology. We described a 55-year-old female teacher with TTC diagnosed after acute psychological stress in workplace. The provoking factor related with occupational stress and pattern of contraction abnormalities documented with AFI technique including basal segments of left ventricle make this case atypical.
authors: Medical University of Lodz, Łódź, Poland (Chair and Department of Cardiology).
authors: Agnieszka
authors: A
authors: Mielczarek
authors: Medical University of Lodz, Łódź, Poland (Chair and Department of Cardiology). kasprzak@ptkardio.pl.
authors: Jarosław Damian
authors: JD
authors: Kasprzak
authors: Nofer Institute of Occupational Medicine, Łódź, Poland (Department of Environmental Epidemiology). and.mar@interia.pl.
authors: Andrzej
authors: A
authors: Marcinkiewicz
authors: Medical University of Lodz, Łódź, Poland (Chair and Department of Cardiology).
authors: Małgorzata
authors: M
authors: Kurpesa
authors: Medical University of Lodz, Łódź, Poland (Chair and Department of Cardiology).
authors: Barbara
authors: B
authors: Uznańska-Loch
authors: Medical University of Lodz, Łódź, Poland (Chair and Department of Cardiology). wierzbowska@ptkardio.pl.
authors: Karina
authors: K
authors: Wierzbowska-Drabik
mesh_terms: D000062:Accidents, Occupational; D017023:Coronary Angiography / Q000379:methods*; D004452:Echocardiography / Q000379:methods*; D004562:Electrocardiography / Q000379:methods*; D005260:Female; D006801:Humans; D008875:Middle Aged; D013315:Stress, Psychological / Q000150:complications* / Q000175:diagnosis; D054549:Takotsubo Cardiomyopathy / Q000000981:diagnostic imaging* / Q000209:etiology; D014057:Tomography, X-Ray Computed / Q000379:methods*; D057188:Workflow
keywords: accident at work; automated function imaging; broken heart syndrome; occupational stress; speckle tracking echocardiography; takotsubo cardiomyopathy