The Octopus Trap of Takotsubo and Stroke: Genetics, Biomarkers and Clinical Management

Abstract

Takotsubo cardiomyopathy (TC) is a reversible cardiomyopathy mimicking an acute coronary syndrome, usually observed in response to acute stress situations. The association between acute ischemic stroke and TC is already known, since it has been previously reported that ischemic stroke can be both a consequence and a potential cause of TC. However, the precise pathophysiological mechanism linking the two conditions is still poorly understood. The aim of our review is to expand insights regarding the genetic susceptibility and available specific biomarkers of TC and to investigate the clinical profile and outcomes of patients with TC and stroke. Since evidence and trials on TC and stroke are currently lacking, this paper aims to fill a substantial gap in the literature about the relationship between these pathologies.

Cardiac Arrest (CA) as the Initial Presentation of Cocaine-Induced Takotsubo Cardiomyopathy (TCM): A Case Report and Review of Literature

“…About 90% of TCM cases are found in women, specifically postmenopausal women, with a mean age of 67-70 years and the risk is about 10 times higher in women than men [ 18 - 19 ]. Several studies have shown that TCM is associated with a history of depression, anxiety, and type-D personality because of an increased norepinephrine response to emotional stress and the presence of identifiable stressful triggers in two-thirds of cases [ 20 ].…”

A Case Report of Takotsubo Cardiomyopathy With Dengue

“…Takotsubo cardiomyopathy which is first described in 1990 is derived from the Japanese term “octopus trap” [ 1 ]. This form of cardiomyopathy is more common in the elderly population with a post-menopausal female preponderance [ 4 ].…”

“…They commonly present with chest pain, dyspnea, and syncope and less commonly, signs of heart failure, tachy/bradyarrhythmias, cardiogenic shock, mitral regurgitation, and sudden cardiac arrest [ 7 ]. Transient ischemic attacks or strokes are likely to develop due to embolization from apical thrombus [ 1 ]. ECG abnormalities show ST-segment elevation, depression, QT prolongation, T inversion, and nonspecific changes as well.…”

“…Takotsubo cardiomyopathy also known as stress cardiomyopathy, apical ballooning syndrome, or “broken heart syndrome” is a syndrome characterized by transient left ventricular dysfunction with apical ballooning [ 1 ]. Though it is a diagnosis of exclusion, co-existing occlusive coronaries in the angiogram or acute rupture of an atherosclerotic plaque cannot completely rule out the diagnosis.…”