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Takotsubo cardiomyopathy
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Takotsubo cardiomyopathy

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Contributors: Amr Salama MD, Ryan Hoefen MD, PhD
Other Resources UpToDate PubMed

Synopsis

Takotsubo cardiomyopathy (also called stress-induced cardiomyopathy, broken heart syndrome, or apical ballooning syndrome) is a distinctive syndrome of reversible left ventricular systolic dysfunction, usually precipitated by an acute emotional or physiologic stress.

Patients usually present with acute chest pain, dyspnea, and/or palpitations similar to acute coronary syndrome (ACS). The frequent presence of ST segment elevation and/or T wave inversion on electrocardiogram (ECG) and an elevated troponin level also mimic ACS.

Potential complications include congestive heart failure and ventricular arrhythmias, so early recognition and treatment are essential.

The name is derived from the appearance of the left ventricle, which is similar to the shape of a Japanese octopus trap, termed "takotsubo" in Japanese.

It is believed to be caused by sympathetic-mediated myocyte injury. Proposed hypotheses include multivessel coronary spasm, acute increased afterload, myocardial stunning, and acute left ventricular outflow tract obstruction. Diseases that cause catecholamine surge, such as pheochromocytoma, thyrotoxicosis, Addisonian crisis, subarachnoid hemorrhage, and chronic obstructive pulmonary disease (COPD) exacerbation, often result in takotsubo cardiomyopathy.

Postmenopausal women account for >90% of cases. The estimated annual incidence is 50 000-100 000 cases in the United States.

Risk factors include hypertension, lack of estrogen, dyslipidemia, smoking, obesity, hyperthyroidism and other thyroid abnormalities, and diabetes mellitus.

Codes

ICD10CM:
I51.81 – Takotsubo syndrome

SNOMEDCT:
441541008 – Takotsubo cardiomyopathy

Look For

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Diagnostic Pearls

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Differential Diagnosis & Pitfalls

Best Tests

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Management Pearls

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Therapy

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Drug Reaction Data

Below is a list of drugs with literature evidence indicating an adverse association with this diagnosis. The list is continually updated through ongoing research and new medication approvals. Click on Citations to sort by number of citations or click on Medication to sort the medications alphabetically.

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References

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Last Reviewed: 09/08/2017
Last Updated: 10/26/2017
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Takotsubo cardiomyopathy
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Takotsubo cardiomyopathy : Chest pain, Emotional stress or trauma, Dyspnea, T wave inversion, ST elevation
Copyright © 2018 VisualDx®. All rights reserved.