Takotsubo-syndrom

Abstract

Abstract Background: Takotsubo cardiomyopati is a recently recognized diagnosis in medical history. It is rapidly reversible form of cardiomyopati resembling acute myocardial infarction. The typical takotsubo pasient presents with acute chest pain and dyspne. On admission the cardiac enzymes are slightly elevated and the electrocardiogram (ECG) often shows abnormalities like ST-segment elevation or depression. T-wave inversion and Q-wave formation also are frequently found. Coronary angiography exposes no significant coronary stenosis. The takotsubo syndrome includes regressive systolic dysfunction, where a left ventriculography reveals transient akinesis of the involved portion of the myocardial wall, usually the apical part, with hyperkinesis of the remaining myocardium, usually the basal part. This leads to ballooning of the noncontracting myocardial wall during systole. Asynergy in right ventricle is less common. The etiology of takotsubo cardiomyopathi is unclear. The hypotheses are many. The purpose of this study was to get a survey over the hypotheses and present them in details. And in addition present the clinic, diagnostic guidelines, treatment and prognosis.

Methods: With help from my supervisor a literature search was conducted using Pubmed. We searched using the term “Takotsubo cardiomyopathy”. The search identified 124 articles. Our purpose was to find reviews and studies describing the disease. Selection of articles was based on relevance according to title and abstract. Studies published in English and Norwegian were considered.

Results: Takotsubo can not be associated with coronary artery disease, even though the symptoms reminds of acute heart infarction. The hypotheses considering pathophysiology range from multivessel coronary spasm, cathecholamine cardiotoxicity and neurogenic stunned myocardium.

Conclusions: Studies shows that takotsubo occurs typically soon after exposure to sudden emotional or physical event. Concepts about the pathogenesis, clinical features, management and prognosis are still evolving.