Takotsubo Cardiomyopathy in Intensive Care Unit: Prevention, Diagnosis and Management
DOI:
https://doi.org/10.17987/icfj.v5i0.214Keywords:
Echocardiography, electrocardiography/abnormalities, takotsubo cardiomyopathy, intensive care unit, cardiac magnetic imagingAbstract
Accurate diagnosis of Takotsubo Cardiomyopathy has substantial prognostic implications in an intensive care unit, given its increased mortality risk and association with life-threatening complications. This report seeks to discuss diagnostic modalities that can be useful in accurately differentiating Takotsubo Cardiomyopathy from Acute Coronary Syndrome, and also briefly discuss prevention and management of this cardiomyopathy in an intensive care unit. For severely critically ill Takotsubo patients with relative contraindications to angiography, intensive clinicians can consider establishing presumptive diagnosis noninvasively by specific electrocardiogram changes, distinctive marked release of cardiac enzymes, characteristic echocardiogram findings, and accurate cardiac magnetic imaging.References
Pullara A, Chinaglia A, Giammaria M, Bequaraj F, Orlando F, Coda L, et al. Takotsubo cardiomyopathy: real life management in the intensive coronary care unit. Minerva Medica. 2013;104:537-44.
Park JH, Kang SJ, Song JK, Kim HK, Lim CM, Kang DH, et al. Left ventricular apical ballooning due to severe physical stress in patients admitted to the medical ICU. Chest. 2005;128:296-302.
Novo G, Giambanco S, Bonomo V, Sutera MR, Giambanco F, Rotolo A, et al. Troponin I/ejection fraction ratio: a new index to differentiate Takotsubo cardiomyopathy from myocardial infarction. International Journal of Cardiology. 2015;180:255-7.
Randhawa MS, Dhillon AS, Taylor HC, Sun Z, Desai MY. Diagnostic utility of cardiac biomarkers in discriminating Takotsubo cardiomyopathy from acute myocardial infarction. Journal of Cardiac Failure. 2014;20:2-8.
Madias JE. Transient attenuation of the amplitude of the QRS complexes in the diagnosis of Takotsubo syndrome. European Heart Journal. 2014;3:28-36.
Singh K, Neil CJ, Nguyen TH, Stansborough J, Chong CR, Dawson D, et al. Dissociation of early shock in takotsubo cardiomyopathy from either right or left ventricular systolic dysfunction. Heart, lung & circulation. 2014;23:1141-8.
Chong CR, Neil CJ, Nguyen TH, Stansborough J, Law GW, Singh K, et al. Dissociation between severity of takotsubo cardiomyopathy and presentation with shock or hypotension. Clinical Cardiology. 2013;36:401-6.
Singh K, Carson K, Hibbert B, Le May M. Natural history of cardiac arrest in patients with takotsubo cardiomyopathy. The American Journal of Cardiology. 2015;115:1466-72.
Singh K, Carson K, Usmani Z, Sawhney G, Shah R, Horowitz J. Systematic review and meta-analysis of incidence and correlates of recurrence of takotsubo cardiomyopathy. International Journal of Cardiology. 2014;174:696-701.
Shewan LG, Coats AJS, Henein M. Requirements for ethical publishing in biomedical journals. International Cardiovascular Forum Journal 2015;2:2.
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