Takotsubo cardiomyopathy

Abstract

ABSTRACT: First described in Japan in the early 1990s, takotsubo cardiomyopathy (TTC) has gained worldwide recognition. TTC is typically precipitated by a transient ballooning of the left ventricular apex after an emotional or physical trigger. A dramatic and characteristic hallmark of TTC is the complete reversibility of ventricular contraction abnormalities within days to weeks. Since the clinical presentation, electrocardiographic findings, and lab tests are often similar to those of acute myocardial infarction (AMI) or acute myocarditis, differential diagnosis is needed to exclude other diseases. Although TTC has been recognized as a benign condition, it is now characterized by substantial morbidity and mortality, which equal those of AMI. In the acute phase, patients are prone to severe complications, such as cardiogenic shock, cardiac rupture and fatal arrhythmia. Therefore monitoring the clinical course is essential to prevent or treat acute complications. Health care professionals also need to consider that TTC onset in a healthcare setting can occur during outpatient medical evaluation or hospitalization for acute illness. This review article summarizes pathophysiology, clinical features, diagnostic evaluation, and treatment of TTC.