The clinical features of takotsubo cardiomyopathy

Abstract

Background: Takotsubo cardiomyopathy is an acute cardiomyopa-thy characterized by transient left ventricular systolic dysfunction induced by emotional or physical stress, including respiratory failure. Aim: The aim of this study was to analyze the clinical features of patients who developed takotsubo cardiomyopathy in respiratory department. Methods: We retrospectively evaluated the characteristics, causes, and outcomes of takotsubo cardiomyopathy experienced in our respiratory department Results: Of 14 patients, 35% were women over 50 years of age. The most frequent trigger was bronchoscopy. Laryngeal reflex in response to irritation of trachea results in elevation of catecholamine level, thereby inducing takotsubo cardiomyopathy. At onset, more than half of the patients did not show typical symptoms such as chest discomfort. 57.1% of cases showed type 2 respiratory failure and 42.9% showed acidosis which might related to elevation of catecholamine level as well. 50.0% of patients had comorbidities of chronic obstructive pulmonary disease (COPD) or asthma, treated regularly with β2stimulant. Since there are abundant β2-stimulant receptors in apical myocardium, repeated treatment with β2-stimulant may have contributed to the disease onset. Some cases complicated with heart failure, but all patients improved. Conclusions: In respiratory department, it is necessary to be aware of takotsubo cardiomyopathy especially when conducting procedures including tracheal manipulation, when using repetitive β2-stimulant, and when a patient shows exacerbation of respiratory failure with hypercap-nia, even without any chest complaints. AP093 SAPS II OR APACHE II IS BETTER TO PREDICT MORTALITY IN MEDICAL ICU PATIENTS

A case of fulminant type 1 diabetes mellitus accompanied by myocarditis

“…In spite of these similarities, stress induced cardiomyopathy was ruled out in this case because of the distribution of affected myocardium and the degree of cardiac enzyme elevations. Catecholamine cardiomyopathy usually affects the apical and the midventricular myocardium [7], but it does not cause diffuse hypokinesis, as was observed in our patient. The cardiac enzyme levels are also elevated in stress induced cardiomyopathy, but the elevations are typically mild in contrast to that observed in the current patient.…”

An Atypical Case of "Takotsubo cardiomyopathy" during Alcohol Withdrawal: Abnormality in the Transient Left Ventricular Wall Motion and a Remarkable Elevation in the ST Segment

“…Akashi et al from our institute previously hypothesized that excessive activation of cardiac catecholamine receptors may have either the result or the origin of this cardiomyopathy (8). The excessive activation of cardiac catecholamine receptors in the left ventricle and the discrepancy in the distribution of sympathetic nerve endings and their receptors could explain the strong appearance of wall motion abnormalities in the anterior wall.…”

Magnetic resonance imaging findings in apical ballooning syndrome or takotsubo cardiomyopathy

“…During the course of the acute phase, complications like pulmonary oedema, cardiogenic shock and fatal arrhythmias may be seen. 3 No definite explanation exists regarding the mechanism for this syndrome. The most widely proposed theory relates to the role of catecholamine secondary to increased sympathetic activity related to endogenous (emotional) or exogenous stresses (trauma or surgical procedure) with elevated levels of catecholamine as seen in these patients.…”