Takotsubo cardiomyopathy

Question 1

pathogenesis of takotsubo?

Answer 1

regional systolic dysfunction of the left ventricle without CAD or plaque rupture

increased catecholamines
endothelial dysfunction - excessive vasoconstriction vasospasm- myocardial stunning particularly in apex

reduced oestrogen can cause endothelial dysfunction

Question 2

risk of takotsubo?

Answer 2

stress, female, post-menopausal, age 58-75, endocrinopathy (phaechromocytoma/ thyrotoxicosis)

Question 3

takotsubo presentation?

Answer 3

chest pain, sob, syncope. light headedness, cardiogenic shock, cardiac , features of heart failure

Question 4

diagnosis of takotsubo?

Answer 4

transient lv wall motion abnormality on echo
absence of another cause
STEMI, t wave inversion, QT prolongation
apical ballooning