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Takotsubo cardiomyopathy

Marc Pineton de Chambrun, Nicolas Bréchot, Alain Combes
PURPOSE OF REVIEW: Temporary circulatory support (TCS) with short-term mechanical circulatory support (MCS) devices is increasingly used as a salvage therapy for patients with refractory cardiogenic shock. This article provides an overview of current devices, their indications and management, and discusses results of recent case series and trials. RECENT FINDINGS: Percutaneous active MCS devices (Impella, TandemHeart…) and venoarterial extracorporeal membrane oxygenation (VA-ECMO) are utilized as a bridge to 'decision' that includes weaning after cardiac function recovery, transplantation, long-term MCS and withdrawal in case of futility...
June 8, 2018: Current Opinion in Critical Care
Kenan Yalta, Mustafa Yilmaztepe, Cafer Zorkun
Takotsubo cardiomyopathy (TTC) is primarily regarded as a form of acute and transient myocardial disease with a variety of characteristic wall-motion abnormalities. Importantly, a significant portion of TTC cases generally present with variable degrees of acute left ventricular (LV) dysfunction with or without clinical HF. On the other hand, LV dysfunction in the setting of TTC has been universally and exclusively considered as a synonym for systolic dysfunction, potentially overlooking other forms of myocardial pathologies, including transient diastolic dysfunction, in this setting...
May 2018: Cardiac Failure Review
Sana Chams, Skye El Sayegh, Mulham Hamdon, Sarwan Kumar, Zain Kulairi
BACKGROUND: Takotsubo cardiomyopathy or stress cardiomyopathy is characterized by transient left ventricular apical ballooning in the absence of coronary occlusion. The underlying pathophysiological mechanism is still unclear but possible causes have been proposed mainly catecholamine cardiotoxicity, followed by metabolic disturbance, coronary microvascular impairment, and multivessel epicardial coronary artery vasospasm. Takotsubo cardiomyopathy accounts for 1-2% of patients presenting with acute coronary syndrome with the majority of patients diagnosed with Takotsubo cardiomyopathy being women > 55 years of age...
June 10, 2018: Journal of Medical Case Reports
Nileshi Saraf, Eric R Woods, Madison Peppler, Sudipta Seal
An organic aptamer functionalized electrochemical transistor has been developed to detect the presence of epinephrine molecule which acts as an excitatory neurotransmitter. The abnormalities in the level of epinephrine are the direct symptoms of some diseases such as Takotsubo cardiomyopathy, myocardial infarction, arrhythmias and other heart related diseases. The present approach is based on immobilization of aptamers on the gate electrode which selectively binds to epinephrine with high affinity. The introduction of epinephrine in the system causes screening of negative charge of aptamers as well as the production of Faradaic current due to oxidation of epinephrine...
May 22, 2018: Biosensors & Bioelectronics
Monika Budnik, Jakub Kucharz, Paweł Wiechno, Tomasz Demkow, Janusz Kochanowski, Elżbieta Górska, Grzegorz Opolski
Cardiovascular complications are a significant problem in systemically treated cancer patients. One such complication is Takotsubo cardiomyopathy, also known as Takotsubo syndrome. It is most frequently defined as a sudden and transient left or right ventricular systolic dysfunction; mimicking acute coronary syndrome, but without the associated changes in coronary arteries. Takotsubo syndrome is a relatively little known complication that appears in the course of oncological treatment, and its incidence has not yet been established...
June 9, 2018: Advances in Experimental Medicine and Biology
Josef Finsterer, Claudia Stöllberger, Chen-Yu Ho
BACKGROUND: Takotsubo syndrome (TTS) is a non-ischemic cardiomyopathy with sudden but transient systolic dysfunction. TTS mimics myocardial infarction clinically, chemically, and electrocardiographically but echocardiography typically shows apical ballooning and coronary angiography is normal. TTS has not been reported in a patient with myasthenia gravis (MG) and polymyositis due to a malignant thymoma. CASE REPORT: Two weeks prior to admission, a 76yo female developed dysarthria, chronic coughing, and disabling myalgias of the entire musculature...
June 8, 2018: International Journal of Neuroscience
Taiichiro Shirai, Akira Onishi, Daisuke Waki, Jun Saegusa, Akio Morinobu
RATIONALE: TAFRO syndrome is a systemic inflammatory disorder characterized by thrombocytopenia, anasarca, fever, reticulin fibrosis, renal dysfunction, and organomegaly. In contrast to that in multicentric Castleman disease, interleukin-6 targeting strategies seem ineffective in some TAFRO syndrome cases; however, the optimal treatment remains unclear. Here, we report 2 cases of TAFRO syndrome, where 1 with cardiomyopathy, successfully treated with tacrolimus. This is the first case report of successful treatment with tacrolimus in TAFRO syndrome...
June 2018: Medicine (Baltimore)
Kentaro Arakawa, Toshikazu Gondo, Kensuke Matsushita, Hideo Himeno, Kazuo Kimura, Kouichi Tamura
A 62-year-old woman with takotsubo cardiomyopathy (TCM) accompanied by cardiogenic shock due to the obstruction of left ventricular outflow tract (LVOT) and massive mitral regurgitation (MR) was admitted to the emergency department. After successful treatment with intensive care, dobutamine stress-echocardiography (DSE) was performed, which showed a dynamic LVOT gradient, severe MR and cardiogenic shock. A histological examination obtained from the right ventricular septum demonstrated hypertrophied and bizarre myocytes, with myocyte disarray...
June 6, 2018: Internal Medicine
Chloe Grace Meyer, Shayef Gabasha, Ravi Gurujal, Thomas Paul Vacek
Takotsubo cardiomyopathy is characterized by transient loss of systolic function in the absence of coronary artery disease. It is significantly more common in post-menopausal women and is typically brought on by intense emotional stress. Pathophysiology is not completely elucidated, but it appears to be related, in part, to excess catecholamine; this results in coronary artery vasospasm, ischemia and eventual ventricular dysfunction. Patient presentation can vary widely, but typically presents similar to acute coronary syndrome...
May 2018: Oxford Medical Case Reports
Nasreen Shaikh, Muhammad Sardar, Aasems Jacob, Sayee Sundar Alagusundaramoorthy, Margaret Eng, John Checton, Ajay Shah
Takotsubo cardiomyopathy (TTC) is a transient systolic dysfunction of the left ventricle which is usually seen in elderly women, often following a physical or emotional stressful event. Little is known about the prognostic factors affecting the recovery of systolic function. Thirty-six patients diagnosed with TTC from January 2006 to January 2017 at our hospital were included. Median time to recovery of ejection fraction (EF) was calculated to be 25 days. Early recovery of ejection fraction was defined as less than or equal to 25 days (group 1) and late recovery was defined as more than 25 days (group 2)...
May 2018: Intractable & Rare Diseases Research
Osamu Manabe, Masanao Naya, Noriko Oyama-Manabe, Kazuhiro Koyanagawa, Nagara Tamaki
Takotsubo cardiomyopathy (TC) is a syndrome of transient left ventricular (LV) dysfunction mimicking acute coronary syndrome. Although the mechanisms underlying the occurrence of TC are unknown, several imaging techniques contribute to its diagnosis. Here we review the current knowledge about TC, in particular, the pathophysiology and the role of imaging including nuclear cardiovascular medicine.
June 1, 2018: Journal of Nuclear Cardiology: Official Publication of the American Society of Nuclear Cardiology
Paweł Iwaszczuk, Bartosz Kołodziejczyk, Tomasz Kruczek, Leszek Drabik, Wojciech Płazak, Monika Komar, Piotr Podolec, Piotr Musiałek
BACKGROUND Neurogenic mechanism is believed to contribute to left ventricular (LV) systolic dysfunction in acute coronary syndromes (ACS); its extreme form is known as takotsubo cardiomyopathy. However, the magnitude of neurogenic contribution to LV dysfunction in all-comer first-time ACS remains unknown. MATERIAL AND METHODS In 120 consecutive patients with first-time ACS (age 66.3±12.3years, 40 women) coronary angiograms were individually matched to the echocardiographic left ventricular (LV) segments (17-segment model)...
June 2, 2018: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
Kento Imajo, Wataru Tomeno, Mineo Kanezaki, Yasushi Honda, Takaomi Kessoku, Yuji Ogawa, Keisuke Yoshida, Masato Yoneda, Hiroyuki Kirikoshi, Masafumi Ono, Tomohiro Kaneta, Tomio Inoue, Takuma Teratani, Satoru Saito, Atsushi Nakajima
BACKGROUND AND AIM: The aim of this study was to assess the efficacy of a new microwave ablation (MWA) system, the Emprint Ablation System, for the ablation of unresectable large liver tumors (> 30 mm). METHODS: Twenty-one hepatic tumors (mean diameter, 34.7 mm) from 21 patients who underwent percutaneous MWA were included in this cross-sectional study. A volume analyzer based on computed tomography (CT) imaging was used for all patients within the month before and month after the procedure to evaluate the shape and volume of ablation zones...
May 30, 2018: Journal of Gastroenterology and Hepatology
Kristin Meigh, Madison Caja, Melinda Sharon, Allison Tadros, Shane Dragan, David Henkel, Joseph Minardi
Takotsubo cardiomyopathy (TCM) is an important condition for the emergency physician to consider in patients with cardiovascular symptoms. A 70-year-old woman presented with chest pain and nausea following emotional trauma. She had an elevated troponin and a normal electrocardiogram with no history of previous cardiac disease. Point-of-care focused cardiac ultrasound (FOCUS) showed reduced left ventricular systolic function with mid to apical hypokinesis. Cardiac catheterization revealed clean coronary arteries and confirmed the suspected diagnosis of TCM...
May 2018: Clinical practice and cases in emergency medicine
R Scott Taylor, Leif Skjerli, John Ashurst
Takotsubo cardiomyopathy, also known as apical ballooning syndrome and stress cardiomyopathy, is a transient systolic and diastolic left ventricular dysfunction with a variety of cardiac wall-motion abnormalities that is increasingly being associated with significant morbidity and mortality. Wellens' syndrome is an electrocardiographic (ECG) pattern in a pain-free patient that is indicative of critical occlusion of the left anterior descending coronary artery requiring immediate cardiac catheterization. The authors report a case of a patient presenting with ECG findings consistent with Wellens' syndrome that was later found to have Takotsubo cardiomyopathy with angiographically normal coronary arteries on cardiac catheterization after a seizure...
August 2017: Clinical practice and cases in emergency medicine
Shokoufeh Hajsadeghi, Mohammad Hossein Rahbar, Aida Iranpour, Ali Salehi, Omolbanin Asadi, Scott R Jafarian
No abstract text is available yet for this article.
June 2018: Anatolian Journal of Cardiology
Maria Marta Maggiotto Sabra, Fernanda Salomão Costa, Jader Cunha de Azevedo, Claudio Tinoco Mesquita, Hein J Verberne
Although Takotsubo cardiomyopathy (TCM) knowledge is increasing, the exact pathophysiology remains unclear. TCM represents 1%-2% of all troponin positive acute coronary syndromes, affects predominantly postmenopausal women, and is commonly preceded by exposure to severe physical or emotional stress. Transient wall motion abnormalities mimicking ST-elevation myocardial infarction is expected as well as increase of troponin levels and echocardiography alterations. This case report is about a patient that as far as we know is the first case that shows the use of myocardial perfusion imaging in the acute phase of TCM...
May 29, 2018: Journal of Nuclear Cardiology: Official Publication of the American Society of Nuclear Cardiology
Mohamed E Taha, Jaafar Al-Khafaji, Abubaker O Abdalla, Christopher R Wilson
BACKGROUND A coronary artery-left ventricular fistula is an anomalous communication between the coronary arteries and the cardiac chambers and is a rare congenital coronary anomaly that is often small and asymptomatic. Takotsubo cardiomyopathy, on the other hand, is a syndrome characterized by transient regional systolic dysfunction of the left ventricle, mimicking myocardial infarction, but in the absence of angiographic evidence of obstructive coronary artery disease or acute plaque rupture. We present the case of an elderly woman who presented with Takotsubo cardiomyopathy and who was incidentally discovered to have an associated coronary artery-left ventricular fistula...
May 29, 2018: American Journal of Case Reports
Elio Prestipino, Martina Squitieri, Lorenzo Razzolini, Luisa Pastò, Paolo Forleo, Maria Pia Amato
BACKGROUND: We report a case of a woman affected by relapsing remitting Multiple Sclerosis who developed acute left ventricular dysfunction in the context of a severe brainstem relapse, one month after an attempt of in-vitro fertilization. DISCUSSION: The characteristics of our case are consistent with the hypothesis of a possible causal association between an acute medulla oblongata lesion and the occurrence of Takotsubo cardiomyopathy. CONCLUSION: Our case adds to previous reports in this field and calls for awareness of this exceptional extra-neurological manifestation of MS...
May 24, 2018: Multiple Sclerosis and related Disorders
Francesco Santoro, Maria Domenica Costantino, Francesca Guastafierro, Giuseppe Triggiani, Armando Ferraretti, Nicola Tarantino, Ardan Saguner, Matteo Di Biase, Natale Daniele Brunetti
BACKGROUND AND AIMS: Systemic inflammatory activation can be observed in both Takotsubo cardiomyopathy (TTC) and acute coronary syndrome (ACS). The aim of this study was therefore to compare circulating cytokine levels during the acute and subacute phase of TTC and ACS. METHODS: One hundred thirty-six consecutive patients were enrolled in the study; after a propensity score matching, 32 TTC patients were compared with 32 subjects with ACS. Clinical baseline features and circulating levels of interleukin(IL)-1β, IL-1α, IL-2, IL-4, IL-6, IL-8, IL-10, IFN-γ, MCP1, EGF, VEGF, TNFα were obtained at admission (t0 ) and after 120 h (t1 )...
May 18, 2018: Atherosclerosis
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