TAKOTSUBO CARDIOMYOPATHY

Question 1

AKA?

Answer 1

stress cardiomyopathy
stress induced cardiomyopathy
apical ballooning syndrome
broken heart syndrome

Question 2

transient regional systolic dysfunction of the LV mimicking MI, but no angiographic evidence of obstructive CAD or acute plaque rupture

mostly female, generally older, not common in critically ill patients

Answer 2

takotsubo cardiomyopathy

Question 3

possible mechanism of takotsubo cardiomyopathy?

Answer 3

coronary vasospasm
catecholamine excess with myocardial stunning
affects the left ventricular mid cavity and apex

Question 4

how is takotsubo cardiomyopathy detected?

Answer 4

ECG

Question 5

how takotsubo cardiomyopathy triggered physically and emotionally?

Answer 5

acute respiratory failure
post surgical or trauma
CNS condition
infection

grief/loss
panic/fear/anxiety
conflict, anger/frustration, stresses

Question 6

takotsubo cardiomyopathy common symptoms?

Answer 6

chest pain
dyspnea
syncope
signs
-heart failure
-tachyarrhythmias
-sudden cardiac arrest 
-mitral regurgitation

Question 7

takotsubo cardiomyopathy lab results?

Answer 7

ST-segment elevation
troponin elevation
BNP elevation

Question 8

diagnostic criteria for takotsubo cardiomyopathy?

Answer 8

transient LV systolic dysfunction

absence of obstructive CAD or plaque rupture

new ST segment elevation and/or T wave inversion, modest elevation in cardiac troponin

absence of pheochromocytoma or myocarditis

Question 9

management?

Answer 9

conservative tx
resolution of the physical or emotional stress
patients who survive the acute episode recover systolic ventricular fxn within one to four weeks