Takotsubo cardiomyopathy: A discussion and case study

Abstract

The advanced practice nurse (APN) is instrumental in differentiating between TCM versus acute myocardial infarction, heart failure, pulmonary edema, dynamic outflow obstruction, and cardiogenic shock. Because of these possible acute and critical presentations, prompt recognition and intervention for patients with TCM are priorities for nurse practitioners.

Clinical Features of Takotsubo Syndrome and Its Differential Diagnostic Criteria in Clinical Nursing Practice: A Review of the Literature

“…Further studies report cases of patients presenting to the emergency department whose diagnosis was confused with AMI due to similar symptoms, relating to chest pain and dyspnea; it has been shown that diagnostic and treatment errors are often present in these situations, and that healthcare personnel training is necessary to prevent emergency situations with non-specific and inadequate treatments [ 1 , 6 , 11 , 15 ].…”

“…Takotsubo cardiomyopathy (TCM), also called stress cardiomyopathy (SC) or stress-induced cardiomyopathy, is a reversible heart disease that mimics the symptoms of an acute myocardial infarction (MI or AMI). An MI is the result of ischemia due to blockage of the coronary vessels, whereas in TCM there is no blockage of the vessels [ 1 – 3 ]. It is an atypical pattern of abnormalities of parietal kinetics such as excessive anomalous movement of the basal wall with medio-ventricular and apical hypokinesia [ 4 ].…”

“…The disease name is due to the resemblance of the characteristic left ventricular (LV) apical ballooning to the traditional Japanese octopus-fishing trap called takotsubo. The image on the echocardiogram of the heart appears with a wide base and a long, thin neck [ 1 , 3 ].…”

“…The human body releases catecholamines during an acute stress response. Common triggers of this disease include hearing tragic news, such as a death or loss, receiving a diagnosis like cancer or other adverse pathologies, undergoing major surgeries, and in some cases, exercise or excitement [ 1 ]. It has been found that patients with SC have elevated levels of circulating catecholamines, from 7 to 34 times the normal value, compared to 2 or 3 times the normal value for patients with an acute MI.…”

“…The connection between stress and illness has been part of popular wisdom for a long time, and even our common language has phrases that describe this condition, such as “scared to death” and “broken heart” [ 1 ]. Undoubtedly, TCM represents a serious and potentially lethal disorder because it can lead to serious complications.…”