CIRCJ : Vol. 68 (2004) , No. 1 77-81

Time Course of Electrocardiographic Changes in Patients With Tako-Tsubo Syndrome
Comparison With Acute Myocardial Infarction With Minimal Enzymatic Release

Satoshi Kurisu¹⁾, Ichiro Inoue¹⁾, Takuji Kawagoe¹⁾, Masaharu Ishihara¹⁾, Yuji Shimatani¹⁾, Suji Nakamura¹⁾, Masashi Yoshida¹⁾, Naoya Mitsuba¹⁾, Takaki Hata¹⁾ and Hikaru Sato¹⁾

1) Department of Cardiology, Hiroshima City Hospital

(Received September 12, 2003)
(Revised manuscript received October 20, 2003)
(Accepted November 5, 2003)

Background The time course of the electrocardiographic (ECG) changes in patients with tako-tsubo syndrome remains unknown. Methods and Results In the present study, 16 patients with tako-tsubo syndrome and 15 patients with anterior acute myocardial infarction with minimal enzymatic release (minimal AMI) were evaluated. Left ventricular dysfunction dramatically resolved approximately 2 weeks later in both groups. In the patients with tako-tsubo syndrome, the admission ECG usually showed ST segment elevation, especially in leads V_3-6. T wave inversion deepened progressively to its first negative peak, which occurred at approximately 3 days. The T wave was shallow for several days and then deepened again, the second negative peak occurring at approximately 2-3 weeks. The QT interval was prolonged as the T wave deepened, and shortened as the T wave became shallow. In the patients with minimal AMI, a similar time course of ECG changes was observed after reperfusion. In general, at 3 days or later during the early phase, T wave inversion was deeper and the QTc interval was longer in tako-tsubo syndrome than in minimal AMI. Conclusions Because the time course of the ECG changes, as well as that of the left ventricular dysfunction, is similar between tako-tsubo syndrome and minimal AMI, these 2 cardiac disorders must be carefully differentiated. (Circ J 2004; 68: 77 - 81)

Key Words:

Electrocardiography; Myocardial contraction; Myocardial infarction; Tako-tsubo