Cardiomiopatía de Takotsubo

Abstract

RESUMENLa cardiomiopatía de Takotsubo o cardiopatía por estrés se diagnostica frecuentemente como un síndrome coronario agudo en mujeres posmenopáusicas, por su presentación clínica, que puede simular un infarto agudo de miocardio: dolor torácico anginoso, cambios del segmento ST y de la onda T en las derivaciones precordiales y elevación de biomarcadores cardíacos de necrosis. Se caracteriza por disfunción sistólica con discinesia transitoria de los segmentos apicales y/o medios del ventrículo izquierdo, en ausencia de enfermedad coronaria significativa. Tiene buen pronóstico y la recuperación ocurre en días a semanas. Describimos los casos de tres mujeres posmenopáusicas con diagnóstico inicial de infarto agudo de miocardio. En la coronariografía no se encontraron lesiones significativas, y en la ventriculografía se observó el abalonamiento apical y medial, que es característico de este síndrome. En todos los casos hubo recuperación completa de la función sistólica a las seis semanas de seguimiento. PALABRAS CLAVE Cardiomiopatía de Takotsubo; Insuficiencia Cardíaca; Síndrome Coronario Agudo SUMMARY Takotsubo cardiomyopathyTakotsubo cardiomyopathy or stress-induced cardiomyopathy is often diagnosed as an acute coronary syndrome in postmenopausal women, because its clinical presentation may mimic an acute myocardial infarction: anginal chest pain, changes in the ST segment and T wave in precordial leads and elevated cardiac biomarkers of necrosis. It is characterized by systolic dysfunction with transient ballooning of the apical and middle portions of the left ventricle, in the absence of significant coronary disease. Prognosis is good and complete recovery occurs in days to weeks. We report three cases of postmenopausal women with initial diagnosis of acute myocardial infarction; no significant coronary lesions were found in the coronary angiography; apical ballooning, characteristic of this syndrome, was observed on left

Características clínicas, demográficas y epidemiológicas de una cohorte de pacientes con síndrome de Takotsubo entre 2011 y 2016 en Medellín, Colombia

“…La mayoría de los datos epidemiológicos del ST provienen de Norteamérica, países asiáticos, europeos y poblaciones caucásicas y negras. En Latinoamérica solo se dispone de reportes de caso y revisiones de tema [15][16][17][18][19][20][21][22] . Es por esto que en la discusión no se compara con Artículos Originales con poblaciones demográficamente similares a la presente en este estudio.…”

Cardiomiopatia de Takotsubo da patogênese ao diagnóstico: estado da arte

“…The classic and most frequent pattern consists of compensatory baseline hyperkinesia and apical dyskinesia, and is therefore called the apical type. Some variants, however, are described: mid-ventricular type, which is characterized by hypokinesia in the middle region of the ventricle, with preservation of the apex; basal type, also called inverted TCM, which consists of basic hypokinesia with apex and middle region preservation (related to pheochromocytoma and subarachnoid hemorrhage); isolated focal type, characterized by dysfunction of cardiac segments; global type (or biventricular TCM), composed of hypokinesia in all cardiac segments, besides being associated with a higher risk of complications and hemodynamic instability; and reverse mid-ventricular type, described as hyperkinesis of the mid-ventricular region with akinesia or apex and base hypokinesia, isolated right ventricular involvement and ventricular apical dysfunction 9,11,56,87,[100][101][102][103][104][105][106] .…”

Mourning and Takotsubo cardiomyopathy: neuroendocrine implications and nutritional management

“…If there is heart failure and volume overload, the use of diuretics is administered 14,21,26 ; in these cases, ensure the presence of food sources of potassium in the composition of the meals, coupled with adequate monitoring in the organic response to avoid other electrolyte disturbances.…”