Stress 'Takotsubo' cardiomyopathy: questions still remain

Masunori Matsuzaki

This article has no abstract so we have provided the first paragraph of the full text.

Stress or 'Takotsubo' cardiomyopathy is a novel heart syndrome characterized by a transient (reversible) left ventricular apical dysfunction. The syndrome was first described in Japan and named 'Takotsubo' cardiomyopathy because the shape of the left ventricular apical ballooning observed resembled a 'tako-tsubo', Japanese for octopus pot or trap. Takotsubo cardiomyopathy is frequently associated with electrocardiographic changes (deep inverted T waves in precordial chest leads, with QT interval prolongation) and chest pain, which can closely resemble acute myocardial infarction or evolving acute coronary syndrome. Major impairment in left ventricular dysfunction is characterized by a distinctive ballooning appearance of the mid and apical left ventricle, sparing in most cases only the hyperkinetic left ventricular basal region. Many studies investigating selective coronary angiography performed in individuals immediately after the onset of symptoms have found no definite evidence of epicardial coronary obstruction. The precise clinical features and the etiologic basis of Takotsubo cardiomyopathy remain unclear, and there is diagnostic difficulty in clinically differentiating this syndrome from acute myocardial infarction. Also, this syndrome can occur during the clinical course of various systemic diseases.

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