Natural History of Cardiac Arrest in Patients With Takotsubo Cardiomyopathy

Takotsubo cardiomyopathy and its relevance to anesthesiology: a narrative review

“…5,20,[43][44][45] In a contemporary series of cardiogenic shock associated with TTCM, the only independent risk factor was a low initial left ventricle ejection fraction (EF), and patients experiencing cardiogenic shock had a much higher 28-day mortality and mortality in the first year following discharge. 45 Other complications include mitral regurgitation (14-25%), 5 dynamic intraventricular gradients with LV outflow tract obstruction (10-25%), 5 sudden death, syncope, cardiac arrest (4-9%), 5,20,43,46 mural thrombosis (1-8%), 5,43 thromboembolism including stroke (1.6%), ruptured ventricle (\ 1%), 5,43,47 and arrhythmias. Arrhythmias occur in up to 44% of patients and lifethreatening arrhythmias occur in about 6%, 5,43,48 including atrial fibrillation (5-47%), ventricular tachycardia (1.2-4.0%), ventricular fibrillation (1-2%), and asystole (0.5-3%).…”

Estimation of Risk Factors for Cardiogenic Shock in Takotsubo Cardiomyopathy: A Retrospective Study

“…In-hospital cardiac mortality from TCM ranges from 0 to 2% (3,13) while all-cause mortality ranges from 0 to 9% (2,6,13,14). A diagnosis of TCM as a cause of cardiac arrest and shock can only be made if the patient survives the initial insult (15). Such patients may get misdiagnosed as myocardial infarction in the absence of catheterization, thus possibly underestimating the prevalence and mortality associated with TCM.…”

Coronary slow flow in the setting of Tako-tsubo cardiomyopathy: A causative factor? An innocent bystander? Or a prognostic sign?

“…Based on this report [8], differentiation of TTC patients who are prone to coronary vasospasm (through coronary injection of a variety of vasoactive substances including ACH during the disease course) might be of potential prognostic value with regard to malign arrhythmogenesis in these patients. As another prognostic index, corrected QT interval (QTc) prolongation on electrocardiogram (ECG) (a well known parameter of sympathetic discharge) was also shown to be associated with cardiovascular arrest due to induction of polymorphic ventricular tachycardia (PVT) during the early course of TTC (particularly within the first few days) [9]. Taken together, a variety of prognostic indices have been proposed in the setting of TTC [5][6][7][8][9].…”