Self-reported symptoms 8weeks after discharge: A comparison of takotsubo syndrome and myocardial infarction.
BACKGROUND
Takotsubo syndrome is a form of acute, reversible heart failure that has gained increasing attention. It affects mostly postmenopausal women, and its acute onset and symptoms mimic acute myocardial infarction. The distinct feature of takotsubo syndrome is the ballooning of a ventricle, but the complete pathophysiological mechanisms are not fully understood. Both short-term and long-term survival are affected, but little is known about the illness experience and self-reported residual symptoms after discharge from hospital.


OBJECTIVE
To measure and compare self-reported residual symptoms between patients with takotsubo syndrome and those with acute myocardial infarction.


METHODS
Questionnaire data measuring self-reported symptoms were collected from 48 patients with takotsubo syndrome and 79 patients with acute myocardial infarction 8weeks after discharge. A multivariate adjusted complete case regression model was used to compare the frequency and severity of symptoms.


RESULTS
Self-reported symptoms 8weeks after discharge differed little between patients with takotsubo syndrome and those with acute myocardial infarction. Both groups reported symptoms, including pain, fatigue, breathlessness, and sleep disturbance. At onset there were significant differences between the groups concerning previous diabetes mellitus, cardiac troponin T, ejection fraction and Killip class. There were no significant between-group differences in frequency or severity of symptoms after adjusting for these differences.


CONCLUSIONS
Patients with takotsubo syndrome experience residual symptoms after discharge. Symptoms in several cardiovascular diseases predict quality of life, re-admission, and mortality. Symptom management should be integrated into follow-up care for patients with takotsubo syndrome. One way of achieving this is through person-centered care.
Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Box 457, 405 30 Gothenburg, Sweden; University of Gothenburg Centre for Person-Centred Care (GPCC), Sahlgrenska Academy, University of Gothenburg, Box 457, 405 30 Gothenburg, Sweden. Electronic address: sara.wallstrom@gu.se.
Sara
S
Wallström
Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Box 457, 405 30 Gothenburg, Sweden; University of Gothenburg Centre for Person-Centred Care (GPCC), Sahlgrenska Academy, University of Gothenburg, Box 457, 405 30 Gothenburg, Sweden.
Kerstin
K
Ulin
Department of Cardiology, Sahlgrenska University Hospital, 413 45 Gothenburg, Sweden; Department of Molecular and Clinical Medicine, The Wallenberg Laboratory, Sahlgrenska Academy, University of Gothenburg, 413 45 Gothenburg, Sweden.
Elmir
E
Omerovic
Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Box 457, 405 30 Gothenburg, Sweden; University of Gothenburg Centre for Person-Centred Care (GPCC), Sahlgrenska Academy, University of Gothenburg, Box 457, 405 30 Gothenburg, Sweden.
Inger
I
Ekman
D000328:Adult; D000368:Aged; D017023:Coronary Angiography / Q000379:methods; D059026:Diagnostic Self Evaluation; D004562:Electrocardiography / Q000379:methods; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000175:diagnosis / Q000503:physiopathology / Q000523:psychology / Q000628:therapy; D010351:Patient Discharge; D011788:Quality of Life; D057566:Self Report; D011795:Surveys and Questionnaires; D013548:Sweden / Q000453:epidemiology; D063189:Symptom Assessment / Q000379:methods / Q000523:psychology; D054549:Takotsubo Cardiomyopathy / Q000175:diagnosis / Q000503:physiopathology / Q000523:psychology / Q000628:therapy; D013997:Time Factors
Cardiac rehabilitation; Myocardial infarction; Person centered care; Self-reported symptoms; Symptom management; Takotsubo syndrome