Simple and Accurate Electrocardiographic Criteria to Differentiate Takotsubo Cardiomyopathy From Anterior Acute Myocardial Infarction

Kosuge, Masami; Ebina, Toshiaki; Hibi, Kiyoshi; Morita, Satoshi; Okuda, Jun; Iwahashi, Noriaki; Tsukahara, Kengo; Nakatani, Tatsuya; Kiyokuni, Masayoshi; Ishikawa, Toshiyuki; Umemura, Satoshi; Kimura, Kazuo

doi:10.1016/j.jacc.2009.12.059

Cited by 169 publications

(135 citation statements)

References 4 publications

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“…45- 48 Kosuge et al retrospectively evaluated 33 TTC patients and 342 patients with a first anterior MI. 48 They reported that the combination of the presence of ST depression in lead aVR and the absence of ST-segment elevation in lead V1 identified TTC with 91% sensitivity, 96% specificity, and 95% predictive accuracy. In addition to the small sample size of TTC patients, there are several limitations of the study.…”

Section: Clinical Presentationmentioning

confidence: 99%

Diagnosis of Takotsubo Cardiomyopathy

Scantlebury

Prasad

2014

Circ J

243

208

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Section: Clinical Presentationmentioning

confidence: 99%

Diagnosis of Takotsubo Cardiomyopathy

Scantlebury

Prasad

2014

Circ J

243

208

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“…It should be noted that the ECG changes in this 63-year-old woman-including T-wave evolution, borderline ST-segment elevation in leads V 2 and V 3 in the absence of inferior reciprocal changes or Q waves and QTc prolongation-were in line with the latest published criteria for differentiating TCM from acute myocardial infarction. [9][10][11] Accurate and prompt diagnosis has substantial prognostic implications in view of the evidence that, in TCM patients, the underlying critical illness is the main driver of mortality rates. 12 A recent case report heightens the importance of physicians' awareness of TCM sequelae in hypovolemic patients: the implication for aggressive fluid resuscitation is obvious.…”

Section: Discussionmentioning

confidence: 99%

Necrotic Bowel Induces Takotsubo-Like Myocardial Injury

Koci¹,

Eltibi²,

Hadley³

et al. 2014

Texas Heart Institute Journal

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Although chest pain in association with ST-segment P atients who report chest pain receive priority attention from emergency department (ED) providers-especially when that pain is associated with electrocardiographic (ECG) changes and with cardiac biomarkers consistent with acute coronary syndrome (ACS). In these cases, a consulting cardiologist needs to quickly decide whether to transfer the patient for invasive heart catheterization. We report a challenging ED clinical situation in which cardiac injury and "acute abdomen" occurred simultaneously. Despite time constraints, a thorough and comprehensive patient evaluation must be performed in order to avoid unnecessary invasive interventions. Case ReportIn July 2012, a 63-year-old woman presented at our emergency room with abdominal pain that had started several hours earlier. An abdominal computed tomogram showed signs of colonic thickening, thereby raising suspicion of ischemic colitis. As evaluated by a surgeon, the patient's clinical status (no guarding or abdominal rebounding), hemodynamic results, and laboratory values (normal lactic acid) did not warrant emergent surgical management. Therefore, the patient was at first treated in the ED via supportive measures that included pain management and the administration of fluids and antibiotics. Six to seven hours later, she reported chest pain. Cardiac enzyme tests, including retroactive measurements of troponin T from the first laboratory draw, showed abnormal levels of troponin T, rising from 0.13 to 0.23 ng/mL (negative <0.03 ng/mL), together with a normal creatine kinase level and an abnormal creatine kinase-MB fraction at 10.5 ng/mL (normal, <5 ng/mL). An ECG showed a 1-to 2-mm ST elevation in leads V 2 and V 3 , which was sufficiently suspect to trigger an urgent cardiology consultation to evaluate the possible need for cardiac catheterization in advance of abdominal surgery.Laboratory data showed a white-cell count of 8.5 ×10 9 /L, a hematocrit of 36.5%, and a platelet count of 191 ×10 9 /L. Two serial measurements of lactic acid were normal. Abdominal computed tomography with contrast agent revealed mildly dilated fluid-filled loops of small bowels, possible small-bowel obstruction secondary to adhesions, and a small area of nondistended small bowel between 2 distended loops.At our bedside evaluation, the patient was very uncomfortable because of diffuse severe pain in the mid-epigastric and lower sternal areas, associated with diaphoresis and nausea. Vital signs were a temperature of 98.3 °F, a heart rate of 90 beats/min, a respiratory rate of 18 breaths/min, an oxygen saturation of 98% on 2 L/min oxygen

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“…4 Most patients with TC are elderly women, whereas the majority of patients with AMI are men. [16][17][18][19][20][21][22][23][24][25][26][27] In healthy individuals, the magnitude of ST-segment elevation in lead V1 is generally smaller in females than in young and middle-aged males. 28 …”

Section: Anterior Ami Identification Of High-risk Patients With a Larmentioning

confidence: 99%

“…27 In our study, the Cabrera sequence was used to display the limb leads (Figures 4,5). 27 The distribution of ST-segment elevation clearly differed between TC and anterior AMI, and this difference facilitated differential diagnosis.…”

Section: Non-st-segment Elevation Acs (Nste-acs)mentioning

confidence: 99%

Implications of Using the Cabrera Sequence for Diagnosing Acute Coronary Syndrome

Kosuge

Kimura

2016

Circ J

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The 12-lead electrocardiogram (ECG) is the important, initial examination for diagnosing acute coronary syndrome (ACS). In the traditional 12-lead ECG display, the precordial leads are displayed in their anatomically contiguous order, which makes it easy to understand the positional relationships between the precordial leads and the heart, but the limb leads are not. The "Cabrera sequence" displays the limb leads in an anatomically contiguous manner, which facilitates understanding of the positional relations between the limb leads and the heart, resulting in more rapid, easy, and accurate ECG interpretation than the traditional limb leads display. This review explores the clinical advantages of the Cabrera sequence as compared with the traditional limb leads display for the diagnosis of ACS. (Circ J 2016; 80: 1087 -1096

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Simple and Accurate Electrocardiographic Criteria to Differentiate Takotsubo Cardiomyopathy From Anterior Acute Myocardial Infarction

Cited by 169 publications

References 4 publications

Diagnosis of Takotsubo Cardiomyopathy

Diagnosis of Takotsubo Cardiomyopathy

Necrotic Bowel Induces Takotsubo-Like Myocardial Injury

Implications of Using the Cabrera Sequence for Diagnosing Acute Coronary Syndrome

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