engleski

Stress Cardiomyopathy

Stress cardiomyopathy (SC) or stress-induced cardiomyopathy or Takotsubo syndrome or broken heart syndrome is an acute and usually reversible heart failure syndrome. The term Takotsubo syndrome (TTS) was first introduced when Sato et al. published their report on five cases in a 1990 Japanese medical textbook. The first case of TTS was recorded in 1983 at Hiroshima City Hospital. Therefore, it was first assumed that this disorder affected only people of Asian descent, as this cardiomyopathy was completely unknown to another part of the world until the first cases were published by French and American research groups in the late 1990s. Desmet et al. presented the first series of cases of Caucasian patients using the term "takotsubo". Takotsubo syndrome got its name from the Japanese word for octopus trap, due to the shape of the left ventricle (LV) at the end of systole, it is described in the literature under different names. No term accurately describes the heterogeneous appearance of the ventricle with which this syndrome can occur. The form of LV is characterized by a temporary abnormality of wall movement and most often has a clinical picture of acute coronary syndrome. Among the various etiologies of heart failure such as coronary artery disease, hypertension, tachyarrhythmias, SC includes a wide range of emotional or physical triggers that result in LV dysfunction. There are different diagnostic definitions of stress cardiomyopathy, Abe et al., they introduced the first diagnostic criteria in 2003. A reversible abnormality of wall movement, temporary ST-T segment abnormalities on the ECG was observed ; minimal evidence of stenosis of the epicardial coronary arteries or vasospasm or microcirculation disorders ; physical or emotional stress as a trigger and possible evidence of acute myocarditis pathohistologically. The mean age of these patients was 74 years, with a predominance of females. After the initial Abe criterion, others were introduced, such as Mayo Clinic Criteria 2008, Gothenburg Criteria 2013, Takotsubo Italian Network Criteria 2014 and Takotsubo HFA Criteria 2016. We can conclude that consensus is still lacking in the diagnosis of this syndrome. However, based on previous knowledge and experience, the so- called InterTAK diagnostic criteria that can help objectify this syndrome. These criteria include: 1) Patients show transient left ventricular dysfunction (hypokinesia, akinesia, or dyskinesia) most commonly as apical ballooning or or abnormalities in wall movement. The right ventricle may also be affected. Ventricular dysfunction is usually wider than the supply area of only one epicardial vessel, although stress cardiomyopathy has been reported in a very limited area (so-called focal stress cardiomyopathy of one coronary artery). 2) An emotional, physical, or combined trigger may precede the occurrence of this cardiomyopathy, but not necessarily ; 3) Neurological disorders (e.g. subarachnoid hemorrhage, stroke / TIA as well as pheochromocytoma are 356 www.hippocratescongress.com also possible triggers for SK ; 4) ECG changes (ST-T segment elevation, ST-T segment depression, T wave inversion and QTc interval prolongation) are the most common changes although sometimes the clinical picture may pass without significant ECG changes ; 5) Levels of cardiac markers (hs- Troponin I, NT-pro BNP and creatinine kinase or CPK-mb) are elevated in most cases ; 6) It is possible to objectify the disease of the coronary arteries in stress cardiomyopathy ; 7) Image or suspicion of myocarditis is rare 8) Women are more often affected after menopause.

Stress Cardiomyopathy ; Takotsubo Syndrome ; Left Ventricular Dysfunction

nije evidentirano