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Clinical presentation, treatment, and long‑term outcomes in patients with takotsubo cardiomyopathy: experience of a single cardiology center

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Author(s): Grzegorz Opolski | Maciej M. Pawlak | Marek F. Roik | Janusz Kochanowski | Piotr Ścisło | Radosław Piątkowski | Janusz Kochman | Grzegorz Karpiński | Robert Kowalik | Marcin Grabowski | Paweł Balsam | Krzysztof J. Filipiak

Journal: Polish Archives of Internal Medicine
ISSN 0032-3772

Volume: 120;
Issue: 6;
Start page: 231;
Date: 2010;
Original page

Keywords: clinical characteristics | management | outcomes | takotsubo cardiomyopathy

ABSTRACT
INTRODUCTION: Takotsubo cardiomyopathy (TTC) is a rare transient cardiomyopathy mimicking acute coronary syndrome (ACS). OBJECTIVES: The aim of the study was to retrospectively analyze the clinical course, treatment strategies, and follow‑up of patients with TTC. PATIENTS AND METHODS: Among all patients hospitalized in the department between January 2005 and January 2010, we identified a group of patients who were fulfilling the modified Mayo Clinic criteria for the diagnosis of TTC. Clinical presentation, hospital course, and clinical outcomes were analyzed. RESULTS: A total of 31 patients with TTC were included into the study; women comprised 93.5% of the study population. The most common symptoms included chest pain and dyspnea caused by emotional or physical stress. Cardiogenic shock was present in 2 subjects and life‑threatening ventricular arrhythmias in 3 other patients. Twenty‑four patients had ST‑segment elevation on the electrocardiogram. A mean left ventricular ejection fraction was 42 ±8.6% during contractility abnormalities, and it increased to 58 ±7.9% during recovery. Troponin I was positive in 30 cases with a mean peak level of 2.7 ±5.1 ng/ml. Follow‑up data were available in 23 patients and a mean follow‑up was 955 ±502.8 days. We did not observe a recurrence of TTC. CONCLUSIONS: TTC is observed mainly in postmenopausal women. Clinical presentation of TTC is almost indistinguishable from ACS, but its course is milder and the outcomes are better.

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