Praxis Medica (Jan 2017)
Takotsubo cardiomyopathy
Abstract
Takotsubo cardiomyopathy was described for the first time by Sato in Japan in 1990. It is also called: stress cardiomyopathy, ampulla cardiomyopathy, transient left ventricular apical ballooning syndrome, 'broken heart' syndrome and takotsubo-like left ventricular dysfunction. It is characterized by finding of transient abnormal wall motion of the left ventricle, without significant coronary artery stenosis (<50% of lumen), typically accompanied by chest pain, dynamic, reversible disorders of ST-T segment and a slight increase in levels of cardiac enzymes. Previously it was thought that this disease occurs primarily in older women, usually in menopause. With the increase of knowledge and experience about this cardiomyopathy, it is more and more often diagnosed in younger people of all ages, even in younger women during pregnancy or childbirth. Etiology of this disease still remains unknown. The trigger for development of this syndrome is usually, but not always, an intensive emotional or physical stress. Pathogenesis is still not clear enough. There are several pathogenetic theories, and the most widely accepted is a catecholamine theory. It is described seven different types of cardiac dysfunction until now, and the most common are apical akinesia of the left ventricle with a compensatory basal hyperkinesia (classical form), akinesia of the middle part of the left ventricle with preserved ability of contraction in the basal and apical regions (MLV form), biventricular akinesia and isolated right ventricular dysfunction. In this paper are presented the latest findings about this cardiomyopathy, by etiopathogenetic, clinical and therapeutic aspects.
