Transient apical ballooning syndrome — clinical characteristics, ballooning pattern, and long-term follow-up in a Swiss population

Abstract Background Transient apical ballooning syndrome (TABS) or Takotsubo cardiomyopathy mimics acute ST-elevation myocardial infarction, but is considered to have a good prognosis with only moderate elevation of myocardial enzymes and full recovery of left ventricular function. Although it is in...

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Bibliographic Details
Published in:International journal of cardiology 2009-07, Vol.135 (3), p.370-375
Main Authors: Eshtehardi, Parham, Koestner, Simon C, Adorjan, Patrick, Windecker, Stephan, Meier, Bernhard, Hess, Otto M, Wahl, Andreas, Cook, Stéphane
Format: Article
Language:English
Subjects:
Acute coronary syndrome
Aged
Biological and medical sciences
Cardiology. Vascular system
Cardiovascular
Cohort Studies
Coronary Angiography - methods
Coronary heart disease
Emotional stress
Female
Follow-Up Studies
Heart
Humans
Male
Medical sciences
Middle Aged
Myocarditis. Cardiomyopathies
Retrospective Studies
ST-segment elevation myocardial infarction
Stress, Psychological - diagnostic imaging
Stress, Psychological - epidemiology
Stress, Psychological - therapy
Switzerland - epidemiology
Takotsubo cardiomyopathy
Takotsubo Cardiomyopathy - diagnostic imaging
Takotsubo Cardiomyopathy - epidemiology
Takotsubo Cardiomyopathy - therapy
Time Factors
Transient apical ballooning syndrome
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Summary:Abstract Background Transient apical ballooning syndrome (TABS) or Takotsubo cardiomyopathy mimics acute ST-elevation myocardial infarction, but is considered to have a good prognosis with only moderate elevation of myocardial enzymes and full recovery of left ventricular function. Although it is increasingly reported, its exact incidence, clinical presentation, and prognosis in non-Asian populations remain largely unknown. Objective To describe the clinical characteristics and long-term follow-up of patients who presented with TABS at our institution over a 3 year-period. Methods Patients were retrospectively retrieved from our local database. Patient charts were carefully reviewed and the diagnosis of TABS was based on the Mayo Clinic diagnostic criteria. Moreover, psychosocial stress or gastrointestinal disease was recorded. Results During the study period, 13,715 coronary angiographies were performed at our institution, including 2459 patients presenting with an acute coronary syndrome (ACS). Forty-one TABS were diagnosed, which represents an incidence of 1.7% of ACS-patients and 0.3% of all coronary angiographies performed, respectively. Mean age was 65 years, with 85% women. Clinical presentations included chest pain, dyspnoea, and cardiogenic shock. A preceding psychological or physical condition perceived as “stress” was reported in 61%. At a mean follow-up of 675 ± 288 days, none of the patients died of cardiac causes, but two patients had a recurrence of symptoms. Conclusions This is the largest cohort of TABS patients reported out of Europe so far. The good overall prognosis and low likelihood of recurrence were confirmed.
ISSN:0167-5273
1874-1754
DOI:10.1016/j.ijcard.2008.03.088