• Dan Med Bull · Aug 2009

    Takotsubo cardiomyopathy. An important differential diagnosis to acute myocardial infarction.

    • Lene Hüche Nielsen, Kim Munk, Ole Goetzsche, Evald Høj Christiansen, and Bjarne Linde Nørgaard.
    • Department of Cardiology, Vejle Hospital, DK-7100 Vejle, Denmark. lehuni@VGS.Vejleamt.dk
    • Dan Med Bull. 2009 Aug 1; 56 (3): 165-8.

    IntroductionSparse information with regard to the electrocardiographic (ECG) changes in Takotsubo cardiomyopathy (TC) is available. The purpose of this study was to describe the clinical characteristics and electrocardiographic changes in a Danish cohort of patients with TC. We discuss the potential pathophysiological mechanisms of TC.MethodsCases were registered during a three year period. Patients who were hospitalized at Skejby Hospital suspected of acute myocardial infarction in whom coronary angiography was performed in the acute or subacute phase were registered. Data were obtained retrospectively from medical records and the hospitals laboratory database.ResultsSeven patients with TC were identified comprising six females and one male (mean age 70, range 53-81 years). In the acute phase all patients had ECG changes compatible with ST-elevation acute myocardial infarction (STEMI), as well as profound impaired left ventricular function with apical ballooning. At follow-up (range 1-82 weeks), both ECG and left ventricular function were normalized in all patients.ConclusionIn the acute phase symptoms and ECG changes resemble those in patients with STEMI, hence acute coronary angiography is indicated in most cases. Pathophysiological aspects are discussed.

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