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Takotsubo cardiomyopathy: a diagnostic challenge
  1. Mehmood Zeb1,2,
  2. Nalyaka Sambu1,
  3. Paul Scott1,2,
  4. Nick Curzen1,2
  1. 1Wessex Cardiothoracic Unit, Southampton University Hospitals NHS Trust, Southampton, UK
  2. 2Southampton University Medical School, Southampton, UK
  1. Correspondence to Dr Mehmood Zeb, Wessex Cardiothoracic Unit, Southampton General Hospital, Tremona Road, Southampton, SO16 6YD, UK; mehmoodzeb{at}hotmail.com

Abstract

The frequency of the diagnosis of takotsubo cardiomyopathy has increased rapidly over the past few years, possibly due to increasing awareness among cardiologists. At initial presentation the diagnosis remains a challenge because of the close similarity between the presentation of takotsubo cardiomyopathy, and that of ST elevation myocardial infarction (STEMI). Recognition of salient aspects of the medical history at presentation are important in order to organise further appropriate investigations such as echocardiography and left ventriculography at the time of coronary angiogram. Takotsubo cardiomyopathy can be easily missed without ventriculography early after presentation because of the transient nature of left ventricular dysfunction, and in many centres left ventriculogram is not done as standard in the setting of STEMI. The authors advocate left ventriculography in all cases of ST elevation who have unobstructed coronaries. The correct diagnosis of takotsubo cardiomyopathy is very important for future advice and management of the patient. The prognosis of this condition is generally excellent with almost all patients returning to normal within a few weeks. This article examines the takotsubo cardiomyopathy literature and discusses the pathophysiology, clinical features, management, and prognosis of this condition in the context of an illustrated case.

  • Accident & emergency medicine
  • cardiomyopathy
  • heart failure
  • myocardial infarction
  • MRI

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Footnotes

  • RWMA, regional wall motion abnormality; TC, takotsubo cardiomyopathy.

  • Funding Dr M Zeb, Dr P Scott and Dr N Curzen undertake research partially funded by an unrestricted grant from Medtronic UK. Dr N Sambu is supported by an unrestricted research grant from Haemonetics.

  • Competing interests None.

  • Patient consent Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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