Role of echocardiography for takotsubo cardiomyopathy: clinical and prognostic implications

Abstract

Takotsubo cardiomyopathy (TTC) is newly-described secondary cardiomyopathy characterized by transient left ventricular (LV) dysfunction, which is increasingly recognized in the field of cardiology.TTC occurs in approximately 2% of the patients with acute coronary syndrome. Its onset is rare; however, its specific features play a crucial role in diagnosing the chest pain in clinical practice. TTC has generally favorable outcome with rapid recovery of LV function; however, an increasing evidence suggests that it should be regarded as a more serious acute cardiac disorder with a variety of complications. Owing to its widespread availability, even in emergency settings, transthoracic echocardiography plays a key role in the diagnostic assessment of TTC and contributes to an increased number of disease detection and incidence reports in contemporary clinical practice. This review focuses on the role of echocardiography in understanding the clinical prognostic implications in patients with TTC.

Cardiogenic Shock Following Cardiac Tamponade and Takotsubo in COVID-19

“…The role of imaging has helped in this regard. Apart from characteristic wall motion abnormalities on echocardiography [ 4 ], mitral regurgitation (systolic anterior motion or tenting), dynamic left ventricular (LV) outflow track obstruction from hyperdynamic basal segments or ventricular thrombus are associated findings. Cardiac MRI is both complementary and confirmatory in helping to characterize Takotsubo [ 5 ].…”

Acute arterial occlusion due to left ventricular thrombus of Takotsubo cardiomyopathy in a young adult: a case report

“…The wall motion abnormality of Takotsubo cardiomyopathy usually extends to the territory comprising the coronary arteries, and it is typically described as apical ballooning due to apical akinesis or hypokinesis with preserved or hypercontractile basal segments [2]. The criteria used to diagnose Takotsubo cardiomyopathy have been described in detail by the Mayo Clinic [5], and it is essential to exclude significant organic stenosis or coronary artery spasm.…”

“…Therefore, the presence of cardiac thrombus should always be assessed to appropriately evaluate the source of acute arterial occlusion. It takes 2-5 days to develop thrombi after onset of Takotsubo cardiomyopathy [2], and acute leg pain was not the cause of Takotsubo cardiomyopathy.…”

The Role of Echocardiography Screening at the Stroke Unit

“…Myxoma accounts for more than 50% of tumors (39). Its most common location is in the left atrium, while fibroelastoma is usually located in the aortic valve (40).…”

“…If we perform TTE in the first hours after the stroke, we can detect transient apical dyskinesia (Tako-tsubo cardiomyopathy). In order to be distinguished from ventricular akinesia by TTE one should observe a wall motion abnormality not restricted to a single coronary artery territory, affecting the mid-ventricular portions of the anterior, inferior, and lateral walls, in a circumferential configuration ( 41 ).…”