Materiały źródłowe

• #1 Takotsubo Syndrome: A Review of Presentation, Diagnosis and Management

  https://pmc.ncbi.nlm.nih.gov/articles/PMC8733363/

  TTS can be difficult to diagnose as the clinical presentation is often similar to acute myocardial infarction. […] As such, TTS should be considered as a differential diagnosis in any patient presenting with chest pain and possible ACS, particularly when accompanied by a preceding intense emotional or physical stress or illness. […] Over the years, a number of diagnostic criteria have been developed, with the most recent being the InterTAK Diagnostic Criteria. […] The most significant changes from the preceding modified Mayo Clinic criteria acknowledges that significant coronary artery disease can co-exist with TTS and is not mutually exclusive, and that while an absence of pheochromocytoma was previously required, the InterTAK diagnostic criteria acknowledge that pheochromocytoma may function as a trigger for TTS.

• #2 Broken Heart Syndrome: Symptoms, Causes and Treatments | Conditions | U.S. NewsCalifornia Consumer Privacy Act (CCPA) Opt-Out Icon

  https://health.usnews.com/conditions/heart-disease/broken-heart-syndrome

  Broken heart syndrome is often mistaken for a heart attack because it shares many of the same symptoms, such as chest pain, shortness of breath and changes in heart function and typically occurs after an emotionally or physically distressing event, such as the loss of a loved one, extreme stress or severe shock. […] The only way to determine whether a person is experiencing broken heart syndrome or a heart attack is through medical testing. Echocardiograms, electrocardiograms, coronary angiograms, cardiac MRI and blood tests can help rule out a heart attack and confirm the diagnosis. […] Because broken heart syndrome and heart attacks are virtually indistinguishable, health care professionals need to run certain tests to properly and accurately diagnose the condition. […] Diagnostic tests for broken heart syndrome include: Echocardiogram. This imaging test uses ultrasound to capture images of the heart’s structure and function, allowing doctors to detect the ballooning of the left ventricle during an episode of broken heart syndrome.

• #3 Broken heart syndrome – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/broken-heart-syndrome/diagnosis-treatment/drc-20354623

  Broken heart syndrome is often diagnosed in an emergency or hospital setting because symptoms mimic those of a heart attack. […] To diagnose broken heart syndrome, a healthcare professional examines you and asks questions about your symptoms and medical history. […] Tests to help diagnose broken heart syndrome include: […] People who have broken heart syndrome often have higher levels of substances called cardiac enzymes in the blood. […] An ECG shows how fast or how slow the heart is beating. ECG results for broken heart syndrome look different from those for a heart attack. […] This test checks for blockages in the heart arteries. It’s done to rule out a heart attack. People with broken heart syndrome often don’t have any blockages. […] It shows how blood flows through the heart and heart valves. It can see if the heart is enlarged or has an unusual shape. These changes may be due to broken heart syndrome. […] This test uses magnetic fields and radio waves to create detailed images of the heart.

• #4 Broken heart syndrome – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/broken-heart-syndrome/diagnosis-treatment/drc-20354623

  Broken heart syndrome is often diagnosed in an emergency or hospital setting because symptoms mimic those of a heart attack. […] To diagnose broken heart syndrome, a healthcare professional examines you and asks questions about your symptoms and medical history. […] Tests to help diagnose broken heart syndrome include: […] People who have broken heart syndrome often have higher levels of substances called cardiac enzymes in the blood. […] An ECG shows how fast or how slow the heart is beating. ECG results for broken heart syndrome look different from those for a heart attack. […] This test checks for blockages in the heart arteries. It’s done to rule out a heart attack. People with broken heart syndrome often don’t have any blockages. […] It shows how blood flows through the heart and heart valves. It can see if the heart is enlarged or has an unusual shape. These changes may be due to broken heart syndrome. […] This test uses magnetic fields and radio waves to create detailed images of the heart.

• #5 Takotsubo Cardiomyopathy

  https://www.svhhearthealth.com.au/conditions/takotsubo-cardiomyopathy

  Takotsubo cardiomyopathy or „Broken Heart Syndrome” is when the heart muscle becomes suddenly stunned or weakened. […] What are the possible tests to diagnose Takotsubo cardiomyopathy? […] Your doctor will perform several tests to rule out a heart attack and confirm your diagnosis. You may need one or more of the following tests to determine the cause of your symptoms: ECG an electrical recording of your hearts action, Blood test to check for enzymes that indicate damage to the heart muscle, Echocardiogram an ultrasound of your heart which studies the hearts shape and detects any abnormal movements of the main pumping chamber, Coronary angiogram – to check the blood flow through your hearts blood vessels (coronary arteries). People with Takotsubo cardiomyopathy dont have a blockage in their coronary arteries, whereas in heart attacks there is a blockage. […] The good news is that the heart muscle usually heals within 2-4 weeks, and most people fully recover within two months.

• #6 Broken heart syndrome | Altru Health System

  https://www.altru.org/health-library/conditions/broken-heart-syndrome

  Broken heart syndrome is often diagnosed in an emergency or hospital setting because symptoms mimic those of a heart attack. […] To diagnose broken heart syndrome, a healthcare professional examines you and asks questions about your symptoms and medical history. You may be asked if you’ve had any major stresses recently, such as the death of a loved one. […] Tests to help diagnose broken heart syndrome include: […] Blood tests. People who have broken heart syndrome often have higher levels of substances called cardiac enzymes in the blood. […] Electrocardiogram (ECG or EKG). This quick test measures the electrical activity of the heart. […] A coronary angiogram. This test checks for blockages in the heart arteries. It’s done to rule out a heart attack. […] An echocardiogram. This test uses sound waves to create pictures of the beating heart. […] Cardiac MRI. This test uses magnetic fields and radio waves to create detailed images of the heart.

• #7 Takotsubo (Stress) Cardiomyopathy (Broken Heart Syndrome) Differential Diagnoses

  https://emedicine.medscape.com/article/1513631-differential

  Physicians should be aware of the presentation of takotsubo (stress) cardiomyopathy (broken heart syndrome), because chest pain after a recent stressor is not necessarily due to anxiety. The chest pain may be more complicated and may deteriorate into dysrhythmias, shock, or both. […] Patients with takotsubo cardiomyopathy do not usually have cardiac risk factors, but their pain should be taken seriously. Also, patients may present to the emergency department (ED) after a natural disaster, and healthcare providers should be aware that the incidence of takotsubo cardiomyopathy might increase soon afterward. These patients should be treated in the ED as having acute coronary syndrome (ACS), be provided supportive treatment, and undergo subsequent cardiology evaluation. […] Takotsubo cardiomyopathy should also be a consideration in young patients who present with symptoms similar to those of coronary heart disease to avoid potentially unnecessary invasive interventions (eg, coronary artery stent placement).

• #8 Broken Heart Syndrome: Symptoms & Causes

  https://my.clevelandclinic.org/health/diseases/17857-broken-heart-syndrome

  Broken heart syndrome occurs in about 2% of people who visit a provider for a suspected heart attack. […] A healthcare provider will complete a physical exam and review your medical history. Then, they may order several tests, like: […] Imaging can show damaged heart areas, but you need coronary angiography to help rule out a heart attack. Unlike a heart attack, broken heart syndrome doesn’t involve blocked arteries in your heart. […] Although there’s no cure for broken heart syndrome (takotsubo cardiomyopathy), most people make a full recovery after taking medicine. […] Most people with broken heart syndrome start to feel better as they receive treatment. That can happen while you’re in the hospital or within hours or days of receiving treatment. […] If you have any of the symptoms of broken heart syndrome (takotsubo cardiomyopathy), seek emergency care. Tests are the only way to know if you’re experiencing broken heart syndrome, a heart attack or another medical issue.

• #9 Diagnosis | Stanford Health Care

  https://stanfordhealthcare.org/medical-conditions/blood-heart-circulation/takotsubo-cardiomyopathy/diagnosis.html

  Electrocardiogram (EKG): This test measures the electrical activity of the heart. EKG results in people with takotsubo cardiomyopathy look similar to those of a heart attack. […] Angiogram: This imaging test uses a special, safe dye and moving x-ray to view the heart arteries. This test helps doctors differentiate between heart attack and takotsubo cardiomyopathy. In a person who has had a heart attack, an angiogram usually shows a blockage. No blockages appear on the angiogram of a person with broken heart syndrome. […] Takotsubo cardiomyopathy has several distinct looks on the left ventriculogram that can confirm the diagnosis. […] Echocardiogram (echo): Sound waves create a moving picture of your heart, giving us information about how well your heart chambers and valves are working. An echo can show the distinct look of your hearts main pumping chamber (left ventricle), determine if your right ventricle is also affected, and track your improvement over time. […] Myocardial perfusion imaging: We inject a small, safe amount of radioactive substance into your blood. The substance shows up on a special camera and lets cardiologists know if and where the heart was damaged.

• #10 Takotsubo Cardiomyopathy – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK430798/

  The most widely accepted criteria are the Mayo Clinic diagnostic criteria for the identification of stress cardiomyopathy. […] The key features; all are required to meet the diagnosis: Transient hypokinesis, akinesis, or dyskinesis in the left ventricular mid segments with or without apical involvement; regional wall motion abnormalities that extend beyond a single epicardial vascular distribution and frequently, but not always, a stressful trigger; the absence of obstructive coronary disease or angiographic evidence of acute plaque rupture; new ECG abnormalities (ST-segment elevation and/or T-wave inversion) or modest elevation in cardiac troponin; the absence of pheochromocytoma and myocarditis. […] Patients with TC often exhibit a dynamic pattern of electrocardiographic (ECG) changes akin to the ECG staging in pericarditis.

• #11 Broken heart syndrome. Diagnostics | PPT

  https://www.slideshare.net/slideshow/broken-heart-syndrome-diagnostics/245335823

  The most common acute ECG findings of Takotusubo cardiomyopathy are ST segment elevation in the precordial leads and T-wave inversion in most leads. […] Diagnosis can be confirmed by findings of normal coronary arteries and apical ballooning of the left ventricle on coronary angiography. […] Most patients that survive the initial episode will regain normal ventricular function with 14 weeks and have a good long term prognosis. […] When the diagnosis is in doubt, takotsubo cardiomyopathy should be treated as acute coronary syndrome until proven otherwise.

• #12 Diagnosing Takotsubo Syndrome | NYU Langone Health

  https://nyulangone.org/conditions/takotsubo-syndrome/diagnosis

  An electrocardiogram (ECG) records the electrical signals in your heart. In someone who has takotsubo syndrome, the test can reveal irregularities that mimic those of a heart attack, but with subtle differences that trained cardiologists at NYU Langone can identify. […] This test uses ultrasound waves to produce detailed images of the hearts structure and function. Takotsubo syndrome gets its name because it often causes the heart to lose its typical shape and instead resemble a Japanese pot for catching octopuses, called a takotsubo. An echocardiogram can review the unusual ballooning pattern of the left ventricle commonly observed in takotsubo syndrome. […] Use of blood tests can detect elevated levels of cardiac enzymes and proteins that typically leak into the blood during heart damage.

• #13 Takotsubo Cardiomyopathy – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK430798/

  Cardiac biomarkers, including troponins and CK-MB, show mild elevation. […] Transthoracic echocardiography demonstrates the wall motion abnormalities classified as: Apical type (typical): there is a systolic apical ballooning of the left ventricle, with depressed mid and apical segments, and also hyperkinesis of the basal walls. […] Cardiovascular magnetic resonance imaging may help diagnose and evaluate stress cardiomyopathy, particularly when the echocardiogram is suboptimal, or there is coexisting coronary artery disease. […] Cardiac catheterization is an invasive procedure of choice when takotsubo cardiomyopathy presents as ST-elevation acute coronary syndrome or troponin-positive acute coronary syndrome.

• #14

  https://www.healio.com/news/cardiology/20210614/takotsubo-cardiomyopathy-my-broken-heart-syndrome-experience

  The ECG pattern during a Takotsubo cardiomyopathy episode can vary from normal to ST depression, ST elevation or even a left bundle branch block. Cardiac biomarkers, including troponin and creatine kinase (CK) can be minimally or markedly elevated. The B-type natriuretic peptide is universally elevated, as well.

• #15 Takotsubo Cardiomyopathy | University of Ottawa Heart Institute

  https://www.ottawaheart.ca/heart-condition/takotsubo-cardiomyopathy

  Takotsubo symptoms are essentially the same for those of a heart attack. And an electrocardiogram (ECG) may show abnormalities like those found in some heart attacks in particular, changes known as ST-segment elevation. Other tests are needed to rule out a heart attack. […] Electrocardiogram (ECG): A simple and painless test that measures and records the electrical activity of your heart. […] Coronary angiogram: A dye test used to detect heart problems, such as blockages or narrowed spots. In Takotsubo, there is no evidence on an angiogram of blockages in the coronary arteries. However, blockages are commonly cause for heart attacks. […] Blood tests to measure cardiac biomarkers: In Takotsubo, there can be a rapid but small rise in cardiac biomarkers (substances released into the blood when the heart is damaged). In a heart attack, cardiac biomarkers take longer to rise but peak higher. […] An echocardiogram (ultrasound image): A test that shows abnormal movements in the walls of the left ventricle. In Takotsubo cardiomyopathy, there is a ballooning of the lower part of the left ventricle (apex).

• #16

  https://www.healio.com/news/cardiology/20210614/takotsubo-cardiomyopathy-my-broken-heart-syndrome-experience

  The ECG pattern during a Takotsubo cardiomyopathy episode can vary from normal to ST depression, ST elevation or even a left bundle branch block. Cardiac biomarkers, including troponin and creatine kinase (CK) can be minimally or markedly elevated. The B-type natriuretic peptide is universally elevated, as well.

• #17 Takotsubo Cardiomyopathy

  https://www.svhhearthealth.com.au/conditions/takotsubo-cardiomyopathy

  Takotsubo cardiomyopathy or „Broken Heart Syndrome” is when the heart muscle becomes suddenly stunned or weakened. […] What are the possible tests to diagnose Takotsubo cardiomyopathy? […] Your doctor will perform several tests to rule out a heart attack and confirm your diagnosis. You may need one or more of the following tests to determine the cause of your symptoms: ECG an electrical recording of your hearts action, Blood test to check for enzymes that indicate damage to the heart muscle, Echocardiogram an ultrasound of your heart which studies the hearts shape and detects any abnormal movements of the main pumping chamber, Coronary angiogram – to check the blood flow through your hearts blood vessels (coronary arteries). People with Takotsubo cardiomyopathy dont have a blockage in their coronary arteries, whereas in heart attacks there is a blockage. […] The good news is that the heart muscle usually heals within 2-4 weeks, and most people fully recover within two months.

• #18 Takotsubo cardiomyopathy (broken-heart syndrome) – Harvard Health

  https://www.health.harvard.edu/heart-health/takotsubo-cardiomyopathy-broken-heart-syndrome

  First described in 1990 in Japan, takotsubo cardiomyopathy is a weakening of the left ventricle, the heart’s main pumping chamber. […] To get a definitive diagnosis, clinicians look for the following: […] An echocardiogram (ultrasound image) or other imaging technique that shows abnormal movements in the walls of the left ventricle. The most common abnormality in takotsubo cardiomyopathy the one that gives the disorder its name is ballooning of the lower part of the left ventricle (apex). […] Most individuals who experience it recover fully within two months and are at low risk for it happening again. […] There is no specific treatment for broken-heart syndrome. It depends on the severity of symptoms, and whether the person has low blood pressure or evidence of fluid backing up into the lungs.

• #19 Takotsubo Cardiomyopathy – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK430798/

  Cardiac biomarkers, including troponins and CK-MB, show mild elevation. […] Transthoracic echocardiography demonstrates the wall motion abnormalities classified as: Apical type (typical): there is a systolic apical ballooning of the left ventricle, with depressed mid and apical segments, and also hyperkinesis of the basal walls. […] Cardiovascular magnetic resonance imaging may help diagnose and evaluate stress cardiomyopathy, particularly when the echocardiogram is suboptimal, or there is coexisting coronary artery disease. […] Cardiac catheterization is an invasive procedure of choice when takotsubo cardiomyopathy presents as ST-elevation acute coronary syndrome or troponin-positive acute coronary syndrome.

• #20 Diagnosis | Stanford Health Care

  https://stanfordhealthcare.org/medical-conditions/blood-heart-circulation/takotsubo-cardiomyopathy/diagnosis.html

  Electrocardiogram (EKG): This test measures the electrical activity of the heart. EKG results in people with takotsubo cardiomyopathy look similar to those of a heart attack. […] Angiogram: This imaging test uses a special, safe dye and moving x-ray to view the heart arteries. This test helps doctors differentiate between heart attack and takotsubo cardiomyopathy. In a person who has had a heart attack, an angiogram usually shows a blockage. No blockages appear on the angiogram of a person with broken heart syndrome. […] Takotsubo cardiomyopathy has several distinct looks on the left ventriculogram that can confirm the diagnosis. […] Echocardiogram (echo): Sound waves create a moving picture of your heart, giving us information about how well your heart chambers and valves are working. An echo can show the distinct look of your hearts main pumping chamber (left ventricle), determine if your right ventricle is also affected, and track your improvement over time. […] Myocardial perfusion imaging: We inject a small, safe amount of radioactive substance into your blood. The substance shows up on a special camera and lets cardiologists know if and where the heart was damaged.

• #21 Takotsubo Cardiomyopathy – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK430798/

  Takotsubo cardiomyopathy presentation is similar to acute coronary syndrome. […] The diagnosis of stress cardiomyopathy should be suspected in adults (particularly postmenopausal women) who present with a suspected acute coronary, particularly when the clinical manifestations and electrocardiographic abnormalities are out of proportion to the degree of elevation in cardiac biomarkers. […] It is important to emphasize that takotsubo cardiomyopathy is a diagnosis of exclusion that can only be made after coronary angiography because of the indistinguishable features from acute coronary disease. […] Several diagnostic criteria were proposed for the diagnosis of takotsubo cardiomyopathy, including the Mayo Clinic criteria, the International Takotsubo Diagnostic Criteria (InterTAK Diagnostic Criteria), and others.

• #22 Broken heart syndrome – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/broken-heart-syndrome/diagnosis-treatment/drc-20354623

  Broken heart syndrome is often diagnosed in an emergency or hospital setting because symptoms mimic those of a heart attack. […] To diagnose broken heart syndrome, a healthcare professional examines you and asks questions about your symptoms and medical history. […] Tests to help diagnose broken heart syndrome include: […] People who have broken heart syndrome often have higher levels of substances called cardiac enzymes in the blood. […] An ECG shows how fast or how slow the heart is beating. ECG results for broken heart syndrome look different from those for a heart attack. […] This test checks for blockages in the heart arteries. It’s done to rule out a heart attack. People with broken heart syndrome often don’t have any blockages. […] It shows how blood flows through the heart and heart valves. It can see if the heart is enlarged or has an unusual shape. These changes may be due to broken heart syndrome. […] This test uses magnetic fields and radio waves to create detailed images of the heart.

• #23 Broken Heart Syndrome: Symptoms & Causes

  https://my.clevelandclinic.org/health/diseases/17857-broken-heart-syndrome

  Broken heart syndrome occurs in about 2% of people who visit a provider for a suspected heart attack. […] A healthcare provider will complete a physical exam and review your medical history. Then, they may order several tests, like: […] Imaging can show damaged heart areas, but you need coronary angiography to help rule out a heart attack. Unlike a heart attack, broken heart syndrome doesn’t involve blocked arteries in your heart. […] Although there’s no cure for broken heart syndrome (takotsubo cardiomyopathy), most people make a full recovery after taking medicine. […] Most people with broken heart syndrome start to feel better as they receive treatment. That can happen while you’re in the hospital or within hours or days of receiving treatment. […] If you have any of the symptoms of broken heart syndrome (takotsubo cardiomyopathy), seek emergency care. Tests are the only way to know if you’re experiencing broken heart syndrome, a heart attack or another medical issue.

• #24 Diagnosis | Stanford Health Care

  https://stanfordhealthcare.org/medical-conditions/blood-heart-circulation/takotsubo-cardiomyopathy/diagnosis.html

  Electrocardiogram (EKG): This test measures the electrical activity of the heart. EKG results in people with takotsubo cardiomyopathy look similar to those of a heart attack. […] Angiogram: This imaging test uses a special, safe dye and moving x-ray to view the heart arteries. This test helps doctors differentiate between heart attack and takotsubo cardiomyopathy. In a person who has had a heart attack, an angiogram usually shows a blockage. No blockages appear on the angiogram of a person with broken heart syndrome. […] Takotsubo cardiomyopathy has several distinct looks on the left ventriculogram that can confirm the diagnosis. […] Echocardiogram (echo): Sound waves create a moving picture of your heart, giving us information about how well your heart chambers and valves are working. An echo can show the distinct look of your hearts main pumping chamber (left ventricle), determine if your right ventricle is also affected, and track your improvement over time. […] Myocardial perfusion imaging: We inject a small, safe amount of radioactive substance into your blood. The substance shows up on a special camera and lets cardiologists know if and where the heart was damaged.

• #25 Takotsubo Cardiomyopathy – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK430798/

  Cardiac biomarkers, including troponins and CK-MB, show mild elevation. […] Transthoracic echocardiography demonstrates the wall motion abnormalities classified as: Apical type (typical): there is a systolic apical ballooning of the left ventricle, with depressed mid and apical segments, and also hyperkinesis of the basal walls. […] Cardiovascular magnetic resonance imaging may help diagnose and evaluate stress cardiomyopathy, particularly when the echocardiogram is suboptimal, or there is coexisting coronary artery disease. […] Cardiac catheterization is an invasive procedure of choice when takotsubo cardiomyopathy presents as ST-elevation acute coronary syndrome or troponin-positive acute coronary syndrome.

• #26 Takotsubo Syndrome: A Review of Presentation, Diagnosis and Management

  https://pmc.ncbi.nlm.nih.gov/articles/PMC8733363/

  A diagnosis of TTS is more likely in institutions with primary percutaneous intervention (PCI) for ST elevation myocardial infarction and non-ST elevation myocardial infarction (NSTEMI) who undergo early invasive management. […] Cardiac magnetic resonance imaging is recommended to exclude infectious myocarditis and diagnosis confirmation of takotsubo syndrome. […] CMR imaging has been previously used in those with atypical features, bystander coronary artery disease or when there is suspicion for myocarditis. […] There is emerging evidence that routine use, particularly in the acute phase, assists in confirming the diagnosis, as well as identification of complications not evident on other imaging modalities. […] CMR has been shown to be highly accurate in diagnosing TTS and useful in excluding other aetiologies that can present with similar biochemical, echocardiographic and angiographical findings such as myocarditis or myocardial infarction. […] The InterTAK diagnostic score can be used in conjunction with the International Expert Consensus Document on Takotsubo Syndrome diagnostic algorithm for assessment of patients presenting with chest pain and/or dyspnoea for whom TTS is suspected.

• #27 Takotsubo cardiomyopathy | Radiology Reference Article | Radiopaedia.org

  https://radiopaedia.org/articles/takotsubo-cardiomyopathy?lang=us

  Takotsubo cardiomyopathy, also known as stress cardiomyopathy, apical ballooning syndrome, or broken heart syndrome, is a condition characterized by transient regional abnormal cardiac wall motion, not confined to a single coronary arterial territory. […] See the separate article on takotsubo cardiomyopathy diagnostic criteria. […] Patients with takotsubo cardiomyopathy can have high levels of serum catecholamines and plasma brain natriuretic peptide (BNP). The secretion pattern of BNP in takotsubo patients can be quite similar to those with myocardial infarction. The cardiac troponin level may also rise modestly. […] Left ventriculography can demonstrate transient dysfunction and ballooning of the left ventricular mid and apical segments. […] On cardiac MRI, four distinct patterns of dyskinesia and ballooning are recognized: apical (most common), biventricular, mid-ventricular, and basal. There is typically an absence of late enhancement on delayed contrast sequences, which differentiates takotsubo cardiomyopathy from anterior STEMI.

• #28 Takotsubo syndrome: the broken-heart syndrome

  https://bjcardio.co.uk/2021/03/takotsubo-syndrome-the-broken-heart-syndrome/

  The diagnosis of TTS is mainly based on proposed guidelines, such as those of the Mayo Clinic, the European Society of Cardiology, and the international diagnostic criteria (InterTAK Diagnostic Score). The latter recommends the use of cardiac magnetic resonance (CMR) imaging to exclude infectious myocarditis and for diagnostic confirmation in patients with wall motion abnormalities extending beyond the myocardial territory of a single coronary artery. […] CMR is increasingly being used as a diagnostic tool in the evaluation of patients with suspected TTS to establish the diagnosis accurately, because it allows the cardiologist to visualise RWMA precisely, quantify global LV and RV functions, and indicate, not just the presence of myocardial oedema representing reversible myocardial injury, but, most importantly, the absence of delayed gadolinium hyperenhancement, allowing the differentiation of TTS from myocardial infarction and myocarditis diseases in which it is present.

• #29 Takotsubo Syndrome: A Review of Presentation, Diagnosis and Management

  https://pmc.ncbi.nlm.nih.gov/articles/PMC8733363/

  A diagnosis of TTS is more likely in institutions with primary percutaneous intervention (PCI) for ST elevation myocardial infarction and non-ST elevation myocardial infarction (NSTEMI) who undergo early invasive management. […] Cardiac magnetic resonance imaging is recommended to exclude infectious myocarditis and diagnosis confirmation of takotsubo syndrome. […] CMR imaging has been previously used in those with atypical features, bystander coronary artery disease or when there is suspicion for myocarditis. […] There is emerging evidence that routine use, particularly in the acute phase, assists in confirming the diagnosis, as well as identification of complications not evident on other imaging modalities. […] CMR has been shown to be highly accurate in diagnosing TTS and useful in excluding other aetiologies that can present with similar biochemical, echocardiographic and angiographical findings such as myocarditis or myocardial infarction. […] The InterTAK diagnostic score can be used in conjunction with the International Expert Consensus Document on Takotsubo Syndrome diagnostic algorithm for assessment of patients presenting with chest pain and/or dyspnoea for whom TTS is suspected.

• #30 Takotsubo Cardiomyopathy – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK430798/

  Takotsubo cardiomyopathy presentation is similar to acute coronary syndrome. […] The diagnosis of stress cardiomyopathy should be suspected in adults (particularly postmenopausal women) who present with a suspected acute coronary, particularly when the clinical manifestations and electrocardiographic abnormalities are out of proportion to the degree of elevation in cardiac biomarkers. […] It is important to emphasize that takotsubo cardiomyopathy is a diagnosis of exclusion that can only be made after coronary angiography because of the indistinguishable features from acute coronary disease. […] Several diagnostic criteria were proposed for the diagnosis of takotsubo cardiomyopathy, including the Mayo Clinic criteria, the International Takotsubo Diagnostic Criteria (InterTAK Diagnostic Criteria), and others.

• #31 Takotsubo Cardiomyopathy – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK430798/

  The most widely accepted criteria are the Mayo Clinic diagnostic criteria for the identification of stress cardiomyopathy. […] The key features; all are required to meet the diagnosis: Transient hypokinesis, akinesis, or dyskinesis in the left ventricular mid segments with or without apical involvement; regional wall motion abnormalities that extend beyond a single epicardial vascular distribution and frequently, but not always, a stressful trigger; the absence of obstructive coronary disease or angiographic evidence of acute plaque rupture; new ECG abnormalities (ST-segment elevation and/or T-wave inversion) or modest elevation in cardiac troponin; the absence of pheochromocytoma and myocarditis. […] Patients with TC often exhibit a dynamic pattern of electrocardiographic (ECG) changes akin to the ECG staging in pericarditis.

• #32 Takotsubo cardiomyopathy – Wikipedia

  https://en.wikipedia.org/wiki/Takotsubo_cardiomyopathy

  Several well regarded institutions of medical research have produced clinical criteria useful in diagnosing TTS. One of the first sets of guidelines was initially published in 2004 and again in 2008 by the Mayo Clinic. Other research institutions proposing diagnostic criteria include the Japanese Takotsubo Cardiomyopathy Study Group, University of Gothenburg, Johns Hopkins University, the Takotsubo Italian Network and the Heart Failure Associates TTS Taskforce of the European Society of Cardiology. All of the research institutions agree on at least two main criteria needed to accurately diagnose TTS: 1) transient left ventricular wall motion abnormality and 2) the absence of a condition obviously explaining this wall motion abnormality (coronary artery lesion, hypoperfusion, myocarditis, toxicity, etc.). Other commonly acknowledged criteria necessary for diagnosis include characteristic EKG changes and mild to modest elevation in cardiac troponin.

• #33 Takotsubo Syndrome: A Review of Presentation, Diagnosis and Management

  https://pmc.ncbi.nlm.nih.gov/articles/PMC8733363/

  TTS can be difficult to diagnose as the clinical presentation is often similar to acute myocardial infarction. […] As such, TTS should be considered as a differential diagnosis in any patient presenting with chest pain and possible ACS, particularly when accompanied by a preceding intense emotional or physical stress or illness. […] Over the years, a number of diagnostic criteria have been developed, with the most recent being the InterTAK Diagnostic Criteria. […] The most significant changes from the preceding modified Mayo Clinic criteria acknowledges that significant coronary artery disease can co-exist with TTS and is not mutually exclusive, and that while an absence of pheochromocytoma was previously required, the InterTAK diagnostic criteria acknowledge that pheochromocytoma may function as a trigger for TTS.

• #34 Takotsubo syndrome: the broken-heart syndrome

  https://bjcardio.co.uk/2021/03/takotsubo-syndrome-the-broken-heart-syndrome/

  The diagnosis of TTS is mainly based on proposed guidelines, such as those of the Mayo Clinic, the European Society of Cardiology, and the international diagnostic criteria (InterTAK Diagnostic Score). The latter recommends the use of cardiac magnetic resonance (CMR) imaging to exclude infectious myocarditis and for diagnostic confirmation in patients with wall motion abnormalities extending beyond the myocardial territory of a single coronary artery. […] CMR is increasingly being used as a diagnostic tool in the evaluation of patients with suspected TTS to establish the diagnosis accurately, because it allows the cardiologist to visualise RWMA precisely, quantify global LV and RV functions, and indicate, not just the presence of myocardial oedema representing reversible myocardial injury, but, most importantly, the absence of delayed gadolinium hyperenhancement, allowing the differentiation of TTS from myocardial infarction and myocarditis diseases in which it is present.

• #35 Takotsubo Syndrome: A Review of Presentation, Diagnosis and Management

  https://pmc.ncbi.nlm.nih.gov/articles/PMC8733363/

  A diagnosis of TTS is more likely in institutions with primary percutaneous intervention (PCI) for ST elevation myocardial infarction and non-ST elevation myocardial infarction (NSTEMI) who undergo early invasive management. […] Cardiac magnetic resonance imaging is recommended to exclude infectious myocarditis and diagnosis confirmation of takotsubo syndrome. […] CMR imaging has been previously used in those with atypical features, bystander coronary artery disease or when there is suspicion for myocarditis. […] There is emerging evidence that routine use, particularly in the acute phase, assists in confirming the diagnosis, as well as identification of complications not evident on other imaging modalities. […] CMR has been shown to be highly accurate in diagnosing TTS and useful in excluding other aetiologies that can present with similar biochemical, echocardiographic and angiographical findings such as myocarditis or myocardial infarction. […] The InterTAK diagnostic score can be used in conjunction with the International Expert Consensus Document on Takotsubo Syndrome diagnostic algorithm for assessment of patients presenting with chest pain and/or dyspnoea for whom TTS is suspected.

• #36 Takotsubo syndrome: the broken-heart syndrome

  https://bjcardio.co.uk/2021/03/takotsubo-syndrome-the-broken-heart-syndrome/

  Takotsubo syndrome also known as broken-heart syndrome, Takotsubo cardiomyopathy, and stress-induced cardiomyopathy is a recently discovered acute cardiac disease first described in Japan in 1991. This review aims to update understanding on the epidemiology, pathophysiology, clinical presentation, diagnosis, and treatment of Takotsubo syndrome, highlighting aspects of interest to cardiologists and general practitioners. […] TTS mimics acute coronary syndrome (ACS) and can be indistinguishable from that disease if the coronary arteries are demonstrated to be normal. In this scenario, a differential diagnosis although challenging is essential for ensuring correct treatment. […] TTS is clinically indistinguishable from acute myocardial infarction (AMI), so its diagnosis is frequently a challenge. A critical score to differentiate TTS from ACS was proposed by the International Takotsubo Registry. This score includes seven criteria, which are given different points according to their diagnostic importance, as shown in table 1. Thus, a patient with a score of 30 points has a predictive probability of 1% of having TTS, and one with 70 points has a probability of approximately 90% of being diagnosed with TTS.

• #37 Takotsubo (Stress) Cardiomyopathy (Broken Heart Syndrome) Differential Diagnoses

  https://emedicine.medscape.com/article/1513631-differential

  Atypical forms of takotsubo cardiomyopathy have been described with varying wall-motion abnormalities, including right ventricular and basal/midventricular akinesia. Clinically, these patients tend to present similarly to the classic form. […] Conditions to consider in the differential diagnosis of takotsubo cardiomyopathy include the following: Esophageal spasm, Gastroesophageal reflux disease, Myocardial infarction, Myocardial ischemia, Myocarditis, Acute pericarditis, Pneumothorax, Cardiogenic pulmonary edema, Pulmonary embolism, Unstable angina. […] Diagnosis of takotsubo cardiomyopathy.

• #38 Takotsubo Syndrome

  https://www.acc.org/Latest-in-Cardiology/ten-points-to-remember/2020/03/30/12/17/Takotsubo-Syndrome

  Takotsubo cardiomyopathy, also called stress cardiomyopathy, apical ballooning syndrome, or broken heart syndrome, is a condition in which left ventricular (LV) dilatation and acute systolic heart failure occur, typically following an emotional or physical stressor. […] The diagnosis is often made when a patient with suspected acute myocardial infarction is found at cardiac catheterization to have no coronary blockage. Revised Mayo Clinic diagnostic criteria include the following: Transient dyskinesis of the LV midsegments, regional wall motion abnormalities beyond a single epicardial vascular distribution, absence of obstructive coronary artery disease or acute plaque rupture, new electrocardiographic abnormalities or modest troponin elevation, absence of pheochromocytoma and myocarditis.

• #39 Takotsubo (Stress) Cardiomyopathy (Broken Heart Syndrome) Differential Diagnoses

  https://emedicine.medscape.com/article/1513631-differential

  Physicians should be aware of the presentation of takotsubo (stress) cardiomyopathy (broken heart syndrome), because chest pain after a recent stressor is not necessarily due to anxiety. The chest pain may be more complicated and may deteriorate into dysrhythmias, shock, or both. […] Patients with takotsubo cardiomyopathy do not usually have cardiac risk factors, but their pain should be taken seriously. Also, patients may present to the emergency department (ED) after a natural disaster, and healthcare providers should be aware that the incidence of takotsubo cardiomyopathy might increase soon afterward. These patients should be treated in the ED as having acute coronary syndrome (ACS), be provided supportive treatment, and undergo subsequent cardiology evaluation. […] Takotsubo cardiomyopathy should also be a consideration in young patients who present with symptoms similar to those of coronary heart disease to avoid potentially unnecessary invasive interventions (eg, coronary artery stent placement).

• #40 Broken Heart Syndrome… Fact or Fiction?

  https://www.smh.com/blog/broken-heart-syndrome-fact-or-fiction

  Broken heart syndrome is a documented but still rather mysterious cardiac phenomenon wherein part of a persons heart suddenly weakens in response to some sort of trauma, dangerously disrupting blood flow. […] The result is a combination of symptoms reminiscent of a heart attackchest pain and shortness of breath, irregular heartbeat, palpitations and fainting. […] Because while broken heart syndrome may not be a heart attack, the condition can be fatal, potentially leading to congestive heart failure, blood clots, dangerously low blood pressure, and more. […] To this day, physicians arent entirely sure what causes broken heart syndrome. […] The good news is that the symptoms of broken heart syndrome are most often temporary, clearing up with some aspirin and ACE inhibitors, a beta blocker or two and some diuretics to avoid edema.

• #41 Risk of Hospital Readmission High for ‘Broken Heart’ Syndrome | NYU Langone News

  https://nyulangone.org/news/risk-hospital-readmission-high-broken-heart-syndrome

  Though not having a heart attack, patients with broken heart syndrome still face considerable risk of hospital readmission and in-hospital death. […] Similarities between the two conditions make diagnosis challenging for physicians. […] Physicians should monitor Takotsubo patients carefully. […] Takotsubo patients should be given a detailed discharge plan and counseled on potential reasons to revisit their doctor, such as difficulty breathing or swelling of the legs, says study co-lead investigator and interventional cardiologist Nathaniel Smilowitz, MD, an assistant professor of medicine at NYU Langone. […] The challenge for the healthcare community is that broken heart syndrome is not as well understood, says study co-lead investigator Anais Hausvater, MD, a postdoctoral fellow at NYU Langone. To help these patients, physicians need to be more aware of this condition.

• #42 Increasing Rate of Diagnosis for People With Broken-Heart Syndrome | Technology Networks

  https://www.technologynetworks.com/diagnostics/news/increasing-rate-of-diagnosis-for-people-with-broken-heart-syndrome-348262

  In almost ten per cent of myocardial infarctions, no obvious cause in the coronary artery can be found. Some of the patients are diagnosed with broken-heart syndrome, while others are left without a diagnosis. A new study from Karolinska Institutet in Sweden suggests that early magnetic resonance (MR) imaging of the heart can greatly increase the rate of diagnosis. […] Cardiovascular magnetic resonance (CMR) is often done when examining patients with MINOCA. CMR approximately ten days after onset can result in a diagnosis in under half the patients, normally takotsubo or myocarditis (inflammation of the heart muscle), according to an earlier study of 150 patients from Karolinska Institutet. […] The results suggest that with early examination more patients can get a correct diagnosis and therefore the right treatment.

• #43 Is Broken Heart Syndrome Real? | American Heart Association

  https://www.heart.org/en/health-topics/cardiomyopathy/what-is-cardiomyopathy-in-adults/is-broken-heart-syndrome-real

  Broken heart syndrome may be misdiagnosed as a heart attack because the symptoms and test results are similar. […] If your health care professional thinks you have broken heart syndrome, you may need coronary angiography, a test that uses dye and special X-rays to show the inside of your coronary arteries. Other diagnostic tests are blood tests, EKG, echocardiography (a painless test that uses sound waves to create moving pictures of your heart) and cardiac MRI. […] To keep tabs on your heart health, your health care professional may recommend an echo about a month after you’re diagnosed with the syndrome. Ask how often you should schedule follow-up visits.

• #44 Broken Heart Syndrome: Causes, Symptoms, and Treatments | SELF

  https://www.self.com/story/understanding-broken-heart-syndrome

  Once it’s clear you’re not having a heart attack, your doctor will check to see if your signs and symptoms were caused by broken heart syndrome. […] There’s no standard treatment for broken heart syndrome. Treatment is similar to treatment for a heart attack until the diagnosis is clear. […] Once it’s clear that broken heart syndrome is the cause of your symptoms, your doctor will likely prescribe heart medications for you to take while you’re in the hospital. […] Procedures that are often used to treat a heart attack, such as balloon angioplasty and stent placement, or even surgery, aren’t helpful in treating broken heart syndrome. […] Broken heart syndrome is usually diagnosed in an emergency or hospital setting, since most people with the condition have symptoms identical to a heart attack. […] There’s a small chance that broken heart syndrome can happen again after a first episode. […] Many doctors recommend long-term treatment with beta blockers or similar medications that block the potentially damaging effects of stress hormones on the heart.

• #45 Takotsubo Cardiomyopathy

  https://www.svhhearthealth.com.au/conditions/takotsubo-cardiomyopathy

  Takotsubo cardiomyopathy or „Broken Heart Syndrome” is when the heart muscle becomes suddenly stunned or weakened. […] What are the possible tests to diagnose Takotsubo cardiomyopathy? […] Your doctor will perform several tests to rule out a heart attack and confirm your diagnosis. You may need one or more of the following tests to determine the cause of your symptoms: ECG an electrical recording of your hearts action, Blood test to check for enzymes that indicate damage to the heart muscle, Echocardiogram an ultrasound of your heart which studies the hearts shape and detects any abnormal movements of the main pumping chamber, Coronary angiogram – to check the blood flow through your hearts blood vessels (coronary arteries). People with Takotsubo cardiomyopathy dont have a blockage in their coronary arteries, whereas in heart attacks there is a blockage. […] The good news is that the heart muscle usually heals within 2-4 weeks, and most people fully recover within two months.

• #46 Broken Heart Syndrome: One Nurse’s Journey to the Diagnosis

  https://nursingcecentral.com/broken-heart-syndrome-diagnosis/

  The signs and symptoms of this syndrome include sudden, severe onset of chest pain and shortness of breath, diaphoresis, irregular heartbeats, hypotension, heart palpitations, and feeling faint. Its temporary, and develops in response to an intense emotional or physical experience, which is why its also called Broken Heart Syndrome or stress cardiomyopathy. […] Treatment includes medications such as beta-blockers or ace inhibitors, which will aid in decreasing the stress on the heart and help the heart muscle recover. Its described as a self-limiting condition, but can return later on. […] The heart muscle usually heals within two to four weeks. Most people affected by this syndrome fully recover within two to three months. […] I was informed that I had experienced a Type 2 heart attack upon my discharge from the hospital a few days later.

• #47 Takotsubo Cardiomyopathy | SCAI – Seconds Count

  https://www.secondscount.org/condition/takotsubo-cardiomyopathy

  While the syndrome is poorly understood, researchers think the left ventricle may be stunned and unable to function because of a surge of stress hormones after the patient experiences trauma. […] The syndrome usually resolves quickly and without lasting damage to the heart, but it can be fatal in rare cases.

• #48 Broken Heart Syndrome: Symptoms & Causes

  https://my.clevelandclinic.org/health/diseases/17857-broken-heart-syndrome

  Broken heart syndrome occurs in about 2% of people who visit a provider for a suspected heart attack. […] A healthcare provider will complete a physical exam and review your medical history. Then, they may order several tests, like: […] Imaging can show damaged heart areas, but you need coronary angiography to help rule out a heart attack. Unlike a heart attack, broken heart syndrome doesn’t involve blocked arteries in your heart. […] Although there’s no cure for broken heart syndrome (takotsubo cardiomyopathy), most people make a full recovery after taking medicine. […] Most people with broken heart syndrome start to feel better as they receive treatment. That can happen while you’re in the hospital or within hours or days of receiving treatment. […] If you have any of the symptoms of broken heart syndrome (takotsubo cardiomyopathy), seek emergency care. Tests are the only way to know if you’re experiencing broken heart syndrome, a heart attack or another medical issue.

• #49 Broken Heart Syndrome: A temporary heart condition triggered by an excessive stress | Bangkok Heart Hospital

  https://www.bangkokhearthospital.com/en/content/broken-heart-syndrome

  To diagnose broken heart syndrome, the cardiologist usually performs a physical exam and ask questions about symptoms as well as medical history. Diagnosis involves: […] Electrocardiography (ECG or EKG). This test measures the electrical activity of the heart. The ECG results for broken heart syndrome appear to be quite similar to those with acute coronary artery disease. […] Echocardiography. As a noninvasive test, it uses sound waves to create images of the hearts size, structure and motion. Echocardiography can show if the left ventricle is in abnormal size with systolic dysfunction, which may be a sign of broken heart syndrome. […] Coronary angiography (CAG). CAG uses X-ray imaging to see the hearts blood vessels. During the procedure, dye is injected into the blood vessels of the heart. Subsequently, coronary computed tomography angiography (CTA Coronary) is deployed to visualize the vessels.

• #50 Takotsubo Cardiomyopathy – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK430798/

  Takotsubo cardiomyopathy presentation is similar to acute coronary syndrome. […] The diagnosis of stress cardiomyopathy should be suspected in adults (particularly postmenopausal women) who present with a suspected acute coronary, particularly when the clinical manifestations and electrocardiographic abnormalities are out of proportion to the degree of elevation in cardiac biomarkers. […] It is important to emphasize that takotsubo cardiomyopathy is a diagnosis of exclusion that can only be made after coronary angiography because of the indistinguishable features from acute coronary disease. […] Several diagnostic criteria were proposed for the diagnosis of takotsubo cardiomyopathy, including the Mayo Clinic criteria, the International Takotsubo Diagnostic Criteria (InterTAK Diagnostic Criteria), and others.

• #51 Takotsubo (Stress) Cardiomyopathy (Broken Heart Syndrome) Differential Diagnoses

  https://emedicine.medscape.com/article/1513631-differential

  Physicians should be aware of the presentation of takotsubo (stress) cardiomyopathy (broken heart syndrome), because chest pain after a recent stressor is not necessarily due to anxiety. The chest pain may be more complicated and may deteriorate into dysrhythmias, shock, or both. […] Patients with takotsubo cardiomyopathy do not usually have cardiac risk factors, but their pain should be taken seriously. Also, patients may present to the emergency department (ED) after a natural disaster, and healthcare providers should be aware that the incidence of takotsubo cardiomyopathy might increase soon afterward. These patients should be treated in the ED as having acute coronary syndrome (ACS), be provided supportive treatment, and undergo subsequent cardiology evaluation. […] Takotsubo cardiomyopathy should also be a consideration in young patients who present with symptoms similar to those of coronary heart disease to avoid potentially unnecessary invasive interventions (eg, coronary artery stent placement).

• #52 Takotsubo Cardiomyopathy • LITFL • ECG Library Diagnosis

  https://litfl.com/takotsubo-cardiomyopathy-ecg-library/

  Transient wall motion abnormality of the left ventricular apex associated with severe emotional or physical stress that usually resolves completely. […] The presentation often mimics a STEMI and angiography is required to definitively differentiate the two conditions. […] Takotsubo cardiomyopathy is difficult to distinguish from STEMI in the ED, and no ECG criteria can be safely used to differentiate between the two conditions. […] If in doubt, you should activate your local code STEMI protocol. […] Takotsubo has a better prognosis than STEMIs with a similar ECG but it is certainly not benign. […] Treatment is largely supportive, and LV function usually spontaneously returns within 21 days of onset. […] Anticoagulation should be initiated in patients with large areas of cardiac hypokinesis, as they are at high risk of cerebrovascular thromboembolic events.

• #53 Takotsubo (Stress) Cardiomyopathy (Broken Heart Syndrome) Differential Diagnoses

  https://emedicine.medscape.com/article/1513631-differential

  Physicians should be aware of the presentation of takotsubo (stress) cardiomyopathy (broken heart syndrome), because chest pain after a recent stressor is not necessarily due to anxiety. The chest pain may be more complicated and may deteriorate into dysrhythmias, shock, or both. […] Patients with takotsubo cardiomyopathy do not usually have cardiac risk factors, but their pain should be taken seriously. Also, patients may present to the emergency department (ED) after a natural disaster, and healthcare providers should be aware that the incidence of takotsubo cardiomyopathy might increase soon afterward. These patients should be treated in the ED as having acute coronary syndrome (ACS), be provided supportive treatment, and undergo subsequent cardiology evaluation. […] Takotsubo cardiomyopathy should also be a consideration in young patients who present with symptoms similar to those of coronary heart disease to avoid potentially unnecessary invasive interventions (eg, coronary artery stent placement).

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