Prevalence of Takotsubo Syndrome among Patients Admitted to an Emergency Department

Abstract

Aim : Takotsubo syndrome (TTS) is identified in 1-3％ of patients with suspected acute coronary syndrome and is a complication of various diseases. This study aimed to clarify the prevalence and clinical characteristics of TTS among patients admitted to the emergency department of a tertiary hospital.
Methods : We conducted a post-hoc analysis of a single-center prospective observational study of all patients admitted to our emergency department between April 2003 and March 2014. The diagnosis of TTS was based on the Mayo diagnostic criteria.
Results : Among 14,178 patients admitted, TTS was diagnosed in 33 patients (male, 36％ ; median age 76 (interquartile range, 70-80) years), with a prevalence rate of 0.23％. The cases without preceding physical illness included 40％ of patients (the primary TTS group), and the cases with preceding physical illness included 60％ of patients (the secondary TTS group). Chest discomfort was the presenting symptom in only 25％ of patients in the secondary TTS group compared to 92％ in the primary TTS group (p＜0.001). The Acute Physiology and Chronic Health Evaluation II scores were higher in the secondary TTS group than in the primary TTS groups (p＝0.002)
Conclusions : The prevalence of TTS among patients admitted to the emergency department was 0.23％. TTS triggered by a physical illness formed a high percentage, and in the majority of these cases chest symptoms were not presenting complaints. Nevertheless, physicians should screen for TTS as part of the assessment of patients admitted to the emergency department.