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Tako-tsubo-like left ventricular dysfunction: transient left ventricular apical ballooning syndrome
E Vizzardi1, A D'Aloia, G Zanini
1Section of Cardiovascular Disease, Department of Applied Experimental Medicine, Department of Cardiology, University Study of Brescia, Brescia, Italy. enrico.vizzardi@tin.it
International Journal of Clinical Practice
|September 23, 2008
Summary
Transient left ventricular apical ballooning, or tako-tsubo cardiomyopathy, mimics heart attacks but resolves quickly. This review covers its epidemiology, mechanisms, and clinical features, emphasizing its importance for emergency diagnoses.
Area of Science:
- Cardiology
- Internal Medicine
Background:
- Transient left ventricular apical ballooning, also known as stress-induced cardiomyopathy or tako-tsubo syndrome, presents clinically similar to acute coronary syndrome.
- It is characterized by temporary apical ballooning of the left ventricle, often triggered by significant psychological or physiological stress.
Purpose of the Study:
- To provide a comprehensive evaluation of the epidemiology, clinical and instrumental features, pathophysiological mechanisms, therapy, and prognosis of tako-tsubo-like syndrome.
- To increase awareness among physicians regarding this condition, particularly in emergency settings.
Main Methods:
- Literature review and data evaluation for a comprehensive consideration of multiple aspects of the syndrome.
Main Results:
- The syndrome predominantly affects women and presents with symptoms like chest pain and dyspnea, mimicking myocardial infarction but without coronary stenosis.
- ECG changes and elevated cardiac enzymes are common, with wall-motion abnormalities resolving within days to weeks.
- Proposed mechanisms include catecholamine cardiotoxicity, coronary microvascular dysfunction, and vasospasm; incidence is highest in Japan but increasing globally.
- Treatment is supportive, and prognosis is generally favorable, though severe complications can occur.
Conclusions:
- Transient left ventricular apical ballooning requires greater recognition by general physicians and cardiologists.
- It should be a key consideration in patients presenting to emergency departments or Chest Pain Units with suspected acute coronary syndrome.
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