Gaspar J, Gómez CRA

Language: Spanish
References: 37
Page: 205-214
PDF size: 241.27 Kb.

ABSTRACT

Tako-Tsubo syndrome (TTS) is a recently described entity that can mimic an acute myocardial infarction. It is characterized by anginal chest pain with ST-T elevation in precordial leads, no coronary obstruction on angiography, and as its distinctive feature, a reversible left ventricular antero-apical ballooning with basal hyperkinesis. TTS is more frequent in female and elderly patients and in an article published in 2001 it was mentioned that only two cases had been reported outside Japan. We describe a typical case of recurrent TTS triggered by intense emotional stress. This is the first case reported from Latin America. A review of the literature suggests that TTS is more frequent than previously thought but apparently due to lack of awareness of this entity it can go unrecognized. Identification of TTS is of clinical importance because its management and prognosis differs significantly from that of an acute myocardial infarction that results from the thrombotic occlusion of a coronary atherosclerotic plaque.

REFERENCES

1. Sato H, Tateishi H, Uchida T: Takotsubo-type cardiomyopathy due to multivessel spasm. En: Kodama K, Haze K, Hon M, editors: Clinical Aspect of Myocardial Injury; From Ischemia to Heart Failure (en japonés). Tokio. Kagakuhyouronsya Co., 1990; p. 56-64.

2. Dote K, Sato H, Teteishi H, Uchida T, Isihara M: Myocardial stunning due to multivessel coronary spasm: a review of 5 cases. J Cardiol 1991; 21:203-214.

3. Tsuchihashi K, Ueshima K, Uchida T, Oh-mura N, Kimura K, Owa M, et al: Transient left ventricular apical ballooning without coronary artery stenosis: a novel heart syndrome mimicking acute myocardial infarction. J Am Coll Cardiol 2001; 38: 11-8.

4. Kawai S, Suziki H, Yamaguchi H, Tanaka K, Sawada H, Aizawa T, et al: Ampulla cardiomyopathy (“Takotsubo” cardiomyopathy). Reversible left ventricular dysfunction with ST segment elevation. Jpn Circ J 2000; 64: 156-159.

5. Matsuoka H, Kawakami H, Koyama Y, Inoue K, Nishimura K, Saeki H, et al: “Takotsubo” cardiomyopathy with a significant pressure gradient in the left ventricle. Heart Vessels 2000; 15: 203.

6. Nyui N, Yamanaka O, Nakayama R, Sawano, Kawai S: “Tako-Tsubo” transient ventricular dysfunction. A case report. Jpn Circ J 2000; 64: 715-719.

7. Owa M, Aizawa K, Urasawa N, Ichinose H, Yamamoto K, Karasawa K, et al: Emotional stress-induced “Ampulla Cardiomyopathy”. Discrepancy between the metabolic and sympathetic innervation imaging performed during the recovery course. Jpn Circ J 2001; 65: 349-352.

8. Kurisu S, Sato H, Kawagoe T, Ishihara M, Shimatani Y, Nishioka K, et al: Tako-tsubo-like left ventricular dysfunction with ST-segment elevation: a novel cardiac syndrome mimicking acute myocardial infarction. Am Heart J 2002; 143: 448-55.

9. Inoue F, Takaoka M, Kumura H, Tohma Y, Shiono S, Tabuse H, et al: So-called “ampulla” cardiomyopathy associated with vasospasm compared with acute myocardial infarction showing similar abnormal left ventricular wall motion: two case reports. J Cardiol 2002; 39: 29-38.

10. Peraira MJR, Segovia CJ, Oteo DJF, Ortiz OP, Fuentes MF, Martin JV: Síndrome de discinesia apical transitoria con una complicación inhabitual. Rev Esp Cardiol 2002; 55: 1328-32.

11. Akahashi YJ, Nakazawa K, Sakahibara M, Miyake F, Sasaka K: Reversible left ventricular dysfunction “Takotsubo” cardiomyopathy related to catecholamine cardiotoxicity. Electrocardiol 2002; 35: 351-356.

12. Abe Y, Kondo M, Matsuoka R, Araki M, Dohyama K, Tanio H: Assessment of clinical features in transient left ventricular apical ballooning. J Am Coll Cardiol 2003; 41: 737-742.

13. Kurisu S, Inoue I, Kawagoe T, Ishihara M, Shimatani Y, Nishioka K, et al: Myocardial perfusion and fatty acid metabolism in patients with Tako-Tsubo-like left ventricular dysfunction. J Am Coll Cardiol 2003; 41: 743-748.

14. Girod JP, Messerli AW, Zidar F, Wilson Tang WH, Brener SJ: Tako-Tsubo-like transient left ventricular dysfunction. Circulation 2003; 107: e120-e121.

15. Kurisu S, Inoue I, Kawagoe T, Ishihara M, Shimatani Y, Nishioka K, et al: Left ventricular apical thrombus formation in patient with suspected Tako-Tsubo-like left ventricular dysfunction. Circ J 2003; 67: 556-558.

16. Ogura R, Hiasa Y, Takahashi T, Yamaguchi K, Fujiwara K, Ohara W, et al: Specific findings of the standard 12-lead ECG in patients with “Takotsubo” cardiomyopathy. Comparison with the findings of acute anterior myocardial infarction. Circ J 2003; 67: 687-690.

17. Abe Y, Kondo M: Apical ballooning of the left ventricle: a distinct entity? Heart 2003; 89: 974-976.

18. Scully RE, Mark EJ, McNeely BU: Case Records of the Massachusetts General Hospital. Case 18-1986. N Engl J Med 1986; 314: 1240-1247.

19. Shaw TRD, Rafferty P, Tait GW: Transient shock and myocardial impairment caused by phaeochromocytoma crisis. Br Heart J 1987; 57: 194-8.

20. Fournier C, Boujon B, Hebert J-L, Zamani K, Grimon G, Blondeau M: Stunned myocardium following coronary spasm. Am Heart J 1991;121:593-595.

21. Tawarahara K, Kurata Ch, Okayama K, Watanabe H, Kobayashi A, Yamazaki N: Reversal of perfusion defect on resting thallium-201 emission computed tomography on stunned myocardium and coronary spasm. Am Heart J 1993; 125: 1425-1427.

22. Kono T, Morita H, Kuroiwa T, Onaka H, Takatsuka H, Fujiwara A: Left ventricular wall motion abnormalities in patients with subarachnoid hemorrhage: neurogenic stunned myocardium. J Am Coll Cardiol 1994;24:636-640.

23. Adachi K, Kawata M, Araki S, Matsumoto A, Mukai T, Ikoma T: A case of crush syndrome with giant negative T waves and reversible left ventricular dysfunction. Jpn Circ J 1996; 60: 809-814.

24. Pavin D, Le Breton H, Daubert C: Human stress cardiomyopathy mimicking acute myocardial syndrome. Heart 1997; 78: 509-511.

25. Joffe II, Riley MF, Katz SE, Ginsburg G, Douglas P: Acquired dynamic left ventricular outflow tract obstruction complicating acute anterior myocardial infarction: serial echocardiographic and clinical evaluation. J Am Soc Echocardiogr 1997; 10: 717-21.

26. Brandspiegel HZ, Marinchak RA, Rials SJ, Kowey PR: A Broken Heart. Circulation 1998; 98: 1349.

27. Sharkey SW, Shear W, Hodges M, Herzog CA: Reversible myocardial contraction abnormalities in patients with an acute concardiac illness. Chest 1998; 114: 98-105.

28. Haley JH, Sinak LJ, Tajik J, Ommen SR, Oh JK: Dynamic left ventricular outflow tract obstruction in acute coronary syndromes: an important cause of new systolic murmur and cardiogenic shock. Mayo Clin Proc 1999; 74: 901-906.

29. Villareal RP, Achari A, Wilansky S, Wilson JM: Anteroapical stunning and left ventricular outflow tract obstruction. Mayo Clin Proc 2001; 76: 79-83.

30. Anjaneyulu A, Reddy VK, Raju K, Rajagopalaraju A, Kumar AS, Ravichandra R: Acute reversible left ventricular dysfunction following general anesthesia. Indian Heart J 2001; 53: 508-510.

31. Gueffet JP, Langlard J-M, Burban M, Chevallier J-C, Brunel P, Crochet D, et al: Can one die of sorrow? Arch Mal Coeur 2001; 94: 1413-1417.

32. Marchionni N, Chechi T, Falai M, Margheri M, Funagalli S: Myocardial stunning associated with a myocardial bridge. Int J Cardiol 2002; 82: 65-67.

33. Kloner RA, Jennings RB: Consequences of brief ischemia: stunning, preconditioning and their clinical implications. Circulation 2001; 104: 2981-2989.

34. Ako J, Takenaka K, Uno K: Reversible left ventricular systolic dysfunction – reversibility of coronary microvascular abnormality. Jpn Heart J 2001; 42: 355-363.

35. Armstrong WF, Marcovitz PA: Dynamic left ventricular outflow obstruction as a complication of acute myocardial infarction. Am Heart J 1996; 131: 827-830.

36. Tse RW, Masindet S, Stavola T, Dervan JP, Lawson WE: Acute myocardial infarction with dynamic outflow obstruction precipitated by intra-aortic balloon counterpulsation. Cathet Cardiovasc Diagn. 1996; 39: 62-66.

37. Arvan S, Varat M: Persistent ST-segment elevation and left ventricular wall abnormalities: A 2-Dimensional echocardiographic study. Am J Cardiol 1984; 53: 1542-1546.