Takotsubo Syndrome: Does the Octopus Trap Hide Dangers?
Takotsubo syndrome (TTS) is a recently identified acute heart syndrome, characterized by regional wall motion abnormalities not justified by the presence of significant coronary artery obstruction. Clinically, TTS closely resembles acute coronary syndromes (ACS) and therefore differential diagnosis...
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doaj-bec1812f4a7a42c9b22578640599a5e32020-11-24T23:06:13ZengCompuscriptCardiovascular Innovations and Applications2009-86182009-87822017-05-012331132410.15212/CVIA.2016.0042Takotsubo Syndrome: Does the Octopus Trap Hide Dangers?Maria Bergami0Peter Louis Amaduzzi1Raffaele Bugiardini2Department of Specialistic, Diagnostic and Experimental Medicine (DIMES), Alma Mater University, Bologna, ItalyDepartment of Specialistic, Diagnostic and Experimental Medicine (DIMES), Alma Mater University, Bologna, ItalyDepartment of Specialistic, Diagnostic and Experimental Medicine (DIMES), Alma Mater University, Bologna, ItalyTakotsubo syndrome (TTS) is a recently identified acute heart syndrome, characterized by regional wall motion abnormalities not justified by the presence of significant coronary artery obstruction. Clinically, TTS closely resembles acute coronary syndromes (ACS) and therefore differential diagnosis may be an important obstacle for its correct clinical management. The prevalence of TTS is estimated to be around 2% of acute myocardial infarctions, and the number of diagnoses has increased in recent years, possibly reflecting our growing understanding of this condition. Given the similarities between TTS and ACS, clinical presentation in these patients is equivocal. However, numerous peculiar traits have been observed, such as the greater prevalence in postmenopausal women and the presence of stressful triggers. Many pathogenetic hypotheses for TTS, such as catecholamine overload and microvascular dysfunction, have been proposed. None of these have been capable of independently explaining the underlying mechanisms. The diagnostic criteria proposed by the Heart Failure Association of the European Society of Cardiology represent a novel attempt to introduce semiquantitative parameters, yet further scientific validation is needed. Contrary to previous opinions, TTS is not always benign, considering the relatively high prevalence of acute complications, an estimated in-hospital mortality similar to that of acute myocardial infarction (1–8%), and a significant rate of recurrences and persistence of symptoms. Clinical management of TTS has been largely based on empirical experience related to ACS, and therefore pharmacological strategies are partially overlapping. An issue of the utmost importance is the lack of randomized prospective data validating diagnostic criteria, risk stratification, and specific therapeutic approaches.http://www.ingentaconnect.com/content/cscript/cvia/2017/00000002/00000003/art00001Takotsubo syndromestress cardiomyopathybroken-heart syndromesex-related myocardial diseases |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Maria Bergami Peter Louis Amaduzzi Raffaele Bugiardini |
spellingShingle |
Maria Bergami Peter Louis Amaduzzi Raffaele Bugiardini Takotsubo Syndrome: Does the Octopus Trap Hide Dangers? Cardiovascular Innovations and Applications Takotsubo syndrome stress cardiomyopathy broken-heart syndrome sex-related myocardial diseases |
author_facet |
Maria Bergami Peter Louis Amaduzzi Raffaele Bugiardini |
author_sort |
Maria Bergami |
title |
Takotsubo Syndrome: Does the Octopus Trap Hide Dangers? |
title_short |
Takotsubo Syndrome: Does the Octopus Trap Hide Dangers? |
title_full |
Takotsubo Syndrome: Does the Octopus Trap Hide Dangers? |
title_fullStr |
Takotsubo Syndrome: Does the Octopus Trap Hide Dangers? |
title_full_unstemmed |
Takotsubo Syndrome: Does the Octopus Trap Hide Dangers? |
title_sort |
takotsubo syndrome: does the octopus trap hide dangers? |
publisher |
Compuscript |
series |
Cardiovascular Innovations and Applications |
issn |
2009-8618 2009-8782 |
publishDate |
2017-05-01 |
description |
Takotsubo syndrome (TTS) is a recently identified acute heart syndrome, characterized by regional wall motion abnormalities not justified by the presence of significant coronary artery obstruction. Clinically, TTS closely resembles acute coronary syndromes (ACS) and therefore differential diagnosis may be an important obstacle for its correct clinical management. The prevalence of TTS is estimated to be around 2% of acute myocardial infarctions, and the number of diagnoses has increased in recent years, possibly reflecting our growing understanding of this condition. Given the similarities between TTS and ACS, clinical presentation in these patients is equivocal. However, numerous peculiar traits have been observed, such as the greater prevalence in postmenopausal women and the presence of stressful triggers. Many pathogenetic hypotheses for TTS, such as catecholamine overload and microvascular dysfunction, have been proposed. None of these have been capable of independently explaining the underlying mechanisms. The diagnostic criteria proposed by the Heart Failure Association of the European Society of Cardiology represent a novel attempt to introduce semiquantitative parameters, yet further scientific validation is needed. Contrary to previous opinions, TTS is not always benign, considering the relatively high prevalence of acute complications, an estimated in-hospital mortality similar to that of acute myocardial infarction (1–8%), and a significant rate of recurrences and persistence of symptoms. Clinical management of TTS has been largely based on empirical experience related to ACS, and therefore pharmacological strategies are partially overlapping. An issue of the utmost importance is the lack of randomized prospective data validating diagnostic criteria, risk stratification, and specific therapeutic approaches. |
topic |
Takotsubo syndrome stress cardiomyopathy broken-heart syndrome sex-related myocardial diseases |
url |
http://www.ingentaconnect.com/content/cscript/cvia/2017/00000002/00000003/art00001 |
work_keys_str_mv |
AT mariabergami takotsubosyndromedoestheoctopustraphidedangers AT peterlouisamaduzzi takotsubosyndromedoestheoctopustraphidedangers AT raffaelebugiardini takotsubosyndromedoestheoctopustraphidedangers |
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