Thromboembolism in Takotsubo cardiomyopathy

Mitsuma, Wataru; Kodama, Makoto; Ito, Masahiro; Kimura, Satoshi; Tanaka, Komei; Hoyano, Makoto; Hirono, Shuichi; Aizawa, Yoshifusa

doi:10.1016/j.ijcard.2008.06.089

Cited by 61 publications

(46 citation statements)

References 13 publications

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“…Prädispo-nierende Faktoren dürften dabei das aus der kontraktilen Dysfunktion resultierende niedrige Herzzeitvolumen und im Besonderen die in der Region des linksventrikulären Apex vorhandenen ungünstigen Flussverhältnisse sein. Die Inzidenz linksventrikulärer Thromben und Thromboembolien liegt im Tako-Tsubo-Register der ALKK bei 3% [27] sowie bei gezielter und systematischer Erhebung an den betroffenen Patienten zwischen 5% und 14% [45,46,47,48]. Aus den Beobachtungen einiger Fallserien wird berichtet, dass das Auftreten linksventrikulärer Thromben die nach dem kardiogenen Schock zweithäufigste Komplikation von Patienten mit TTC darstellt [48,49].…”

Section: Thrombus/thromboembolieunclassified

Patientenversorgung in der akuten Phase der stressinduzierten Kardiomyopathie (Tako-Tsubo-Kardiomyopathie) – und danach?

Kurowski

Radke

Schunkert

et al. 2010

Herz

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The prognosis of patients presenting with Tako-Tsubo cardiomyopathy (TTC) is generally considered to be favorable. However, in the acute phase of the disorder complications are not infrequent and, therefore, continuous monitoring and consistent therapy in an intensive care unit is essential. Typical complications in patients with TTC are cardiogenic shock, obstruction of the left ventricular outflow tract (LVOT), occasionally accompanied by acute mitral regurgitation, arrhythmias, predominantly torsade de pointes tachycardias due to QT prolongation, left ventricular (LV) thrombus formation with or without consecutive thromboembolic events, and LV rupture. After confirmation of TTC by coronary angiography, repeat echocardiography should be performed. A standardized therapy for patients with TTC has so far not been established. Recommendations for the acute phase include the administration of anxiolytic agents for patients who present with preceding emotional stress, consistent therapy of physical stressors (such as pain or asthma) and avoidance of catecholamine therapy. Shock due to LVOT obstruction is treated by administration of volume and β-blockers. With respect to the occurrence of torsade de pointes tachycardias, drugs which might cause QT prolongation should not be given. The notable incidence of LV thrombus formation justifies therapeutic anticoagulation. Systematic studies and treatment recommendations for the prophylaxis of recurrent TTC do not exist. The recently reported association between TTC and malignant disorders should prompt tumor screening and subsequent preventive medical checkups in patients affected by TTC.

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Section: Thrombus/thromboembolieunclassified

Patientenversorgung in der akuten Phase der stressinduzierten Kardiomyopathie (Tako-Tsubo-Kardiomyopathie) – und danach?

Kurowski

Radke

Schunkert

et al. 2010

Herz

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“…Patients with a left ventricular mural thrombus should be treated with anticoagulation therapy because of the risk of systemic thromboembolism. Mitsuma et al (11) suggested that anticoagulation therapy should be performed until cardiac wall motion abnormalities have improved. However, anticoagulant therapy in thromboembolic diseases is inappropriately underutilized in China because of concerns regarding hemorrhagic complications (12).…”

Section: Ct S H O We D a T H R O Mb U S A T T A C H Me N T T O T H mentioning

confidence: 99%

Concurrent Pheochromocytoma, Ventricular Tachycardia, Left Ventricular Thrombus, and Systemic Embolization

Zhou

Ding

2009

Intern. Med.

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“…There have been several reports on cardiac thrombi involved in cardiac hypofunction states such as myocardial infarction (16), cardiomyopathy (17,18), myocarditis (19), Takotsubo cardiomyopathy (20), and arrhythmias (21). Cardiac thrombi are divided into two types: right-sided and leftsided.…”

Section: Discussionmentioning

confidence: 99%

Hypertensive Crisis and Left Ventricular Thrombi after an Upper Respiratory Infection during the Long-term Use of Oral Contraceptives

Suzuki

Mizuno

et al. 2016

Intern. Med.

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A 34-year-old woman who had been using oral contraceptives for 10 years developed hypertensive crisis with papilloedema after an upper respiratory infection. Laboratory data showed hyperreninemic hyperaldosteronism and elevated levels of fibrinogen, fibrin, and fibrinogen degradation products. Echocardiography demonstrated two masses (18 mm) in the left ventricle. On the fourth hospital day, cerebral infarction, renal infarction, and upper mesenteric artery occlusion suddenly occurred despite the blood pressure being wellcontrolled using anti-hypertensive drugs. Echocardiography revealed the disappearance of the left ventricular masses, which suggested left ventricular thrombi. Cessation of the contraceptives and administration of heparin, warfarin, and anti-platelets drugs improved her general condition.

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Thromboembolism in Takotsubo cardiomyopathy

Cited by 61 publications

References 13 publications

Patientenversorgung in der akuten Phase der stressinduzierten Kardiomyopathie (Tako-Tsubo-Kardiomyopathie) – und danach?

Patientenversorgung in der akuten Phase der stressinduzierten Kardiomyopathie (Tako-Tsubo-Kardiomyopathie) – und danach?

Concurrent Pheochromocytoma, Ventricular Tachycardia, Left Ventricular Thrombus, and Systemic Embolization

Hypertensive Crisis and Left Ventricular Thrombi after an Upper Respiratory Infection during the Long-term Use of Oral Contraceptives

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