Is Takotsubo syndrome (TTS) a new condition? 2014. They include: If you experience these symptoms call 111 immediately and wait for an ambulance. 3Becher, T., El-Battrawy, I., Baumann, S., Fastner, C., Behnes, M., Loßnitzer, D., Elmas, E., Hoffmann, U., Papavassiliu, T., Kuschyk, J. and Dösch, C., 2016. 6Cebelin, M.S. Characteristics and long-term outcome of right ventricular involvement in Takotsubo cardiomyopathy. Emotional triggers may be associated with severe emotional upset such as the death of a loved one or extreme fear due to a life threatening event. It may be helpful to hear from others who have experienced takotsubo. Takotsubo cardiomyopathy. Patient recovery is fast and not provide any prolonged health effect. Am J Psychiatry, 144, pp.1327-30. Stress induces Takotsubo syndrome. and Maron, B.J., 2011. Usual time of recovery occurs within one month and medications require to continue for a period of three to six months. TTS and ACS share many clinical There is no clearly identifiable trigger for around 30% of people who develop TTS. 2Dias, A., Gil, I.J.N., Santoro, F., Madias, J.E., Pelliccia, F., Brunetti, N.D., Salmoirago-Blotcher, E., Sharkey, S.W., Eitel, I., Akashi, Y.J. It was also thought that TTS only affected the lower part (apex) of the left ventricle, and so researchers thought that there may be something different about this section of the heart. primary Takotsubo syndrome (initial presenting problem) Underlying etiology in ~1-2% of patients who present with chest pain and troponin elevation. About Takotsubo. Although it appears that TTS can occur in males and females across the lifespan, around 90% of reported cases to date occur in post-menopausal women.8 Males more often have a physical trigger for TTS, such as acute medical illness or trauma, and usually have worse outcomes when compared to women.14. 7Kahn, J.P., Drusin, R.E. 8Ghadri, J.R., Sarcon, A., Diekmann, J., Bataiosu, D.R., Cammann, V.L., Jurisic, S., Napp, L.C., Jaguszewski, M., Scherff, F., Brugger, P. and Jäncke, L., 2016. These variants include: In the initial phases of TTS, the EF is reduced below 50%. If you would like to know a bit more about the EF, check out the American Heart Association video ‘Ejection fraction measurement and heart failure‘. In a normal heart, the left ventricle contracts strongly and uniformly to eject the blood out of the heart to supply the rest of the body. Everyone experiences some degree of emotional and physical stress during their lifetime, but not everyone has an episode of TTS. The following patterns have been described: TTS can also be triggered by psychologically stressful events that seem far less extreme, such as an argument or loss of a personal possession. TTS can even be triggered by a happy event that triggers strong emotions, such as a family reunion or a lottery win. Certain triggering factors may positively influence Takotsubo syndrome3,4,6. Takotsubo Syndrome Overview; Proposed causative mechanisms; Associated triggers; Drugs that may cause Takotsubo. 3) The inverted (reverse) or basal pattern  is characterised by basal and mid-ventricular segment hypokinesis or akinesis with preserved contractility or hypercontractility of apical segments. The left ventricle is the main pumping chamber of the heart and due to sudden physical stress or emotional incidence influence to narrowing the chamber and weakening of the left ventricle causes disturbance of the blood circulation. In the setting of bereavement, the term ‘broken heart syndrome’ is often used. Takotsubo syndrome is left ventricular dysfunction of the heart and occurs due to excessive stress. Although lost love, or loss of a loved one, has been known to trigger TTS, this is but one context in which TTS occurs. 14Weidner, K. J., El-Battrawy, I., Behnes, M., Schramm, K., Fastner, C., Kuschyk, J., … & Akin, I. Real stories, healthy recipes and frequently-asked questions from people with heart disease, plus a whole lot more. During a takotsubo event there is no blockage in the arteries, instead there is temporary ‘stunning’ of heart muscle. In this test magnetic field is produced by the body and that can create detailed internal body images. It is characterized by substantial morbidity and mortality, which equal those of acute coronary syndromes (ACS) and are still underappreciated [(1)][1]. sex differences of in-hospital outcome and long-term mortality in patients with Takotsubo cardiomyopathy. Read about Sarah’s journey with takotsubo or connect with other people on the international Takotsubo Facebook support group. It was thought that TTS could only affect the bottom of the left ventricle (known as the apex). If you want to participate or find out more email Mandy Fish at Auckland District Health Board or phone +64 9 307 4949 ext 24366. Or you can also contact us by filling the online contact form. Talk to your cardiac rehab nurse about the services in your area that best meet your needs. Figure 1: The normal heart and structures. The wall of the ventricle is weakened and takes on an abnormal shape. Japanese researchers were the first to name this condition, hence the Japanese name ‘takotsubo’ which refers to a pot used to catch an octopus. It leads to an incorrect assumption by those that do not know much about the condition, that TTS is related to lost love or disappointment in a romantic relationship, and this can cause frustration for people with a physical or unidentified cause of TTS. Physical triggers for TTS include medical illness, extreme exertion or exercise, physical trauma, heat stress, medical tests and procedures, surgery and anaesthesia and some medications. In about a third of cases, people are unable to identify any kind of stress that might have triggered their event. 1) The classical pattern (apical ballooning) is the most frequently recognised pattern and is present in up to 80% of patients. Chest X-ray helps to exclude the involvement of the lungs disorder, whereas X-ray image assists in detecting enlargement of the heart. European Heart Journal-Cardiovascular Imaging, 16(12), pp.1406-1406. It has been assumed that 5% of total reported case of heart attack, specifically in women is actually Takotsubo syndrome, as both the conditions have a similar type of symptoms3,4. Takotsubo syndrome is left ventricular dysfunction of the heart and occurs due to excessive stress. Takotsubo is also called stress-induced cardiomyopathy or broken heart syndrome because, in some cases, it is triggered by a stressful event. The basal pattern is present in 2-5% of patients. Women are more susceptible than men and incidence rate is more in women. Human pathology, 11(2), pp.123-132. TTS has been given several names since it was first recognised – in fact, more than 75 different names have been used in various publications to describe this condition.5 The reason for the name changes is that as we have learned more about the condition, the previous names did not correctly describe the condition. Some risk factors are considered to promote Takotsubo syndrome, which include. Catecholamines are released into the bloodstream in response to stress, and cause physiological changes within the body called ‘the fight or flight response’. Human stress cardiomyopathy: myocardial lesions in victims of homicidal assaults without internal injuries.

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