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Cardiology. 2009;112(1):42-8. doi: 10.1159/000137698. Epub 2008 Jun 26.

Tako-Tsubo-like cardiomyopathy: specific ECG findings, characterization and clinical findings in a European single center.

Author information

1
Department of Cardiology, Krankenhaus Hetzelstift, Neustadt/Weinstrasse, Germany. h.vonkorn@new.marienhaus-gmbh.de

Abstract

OBJECTIVES:

A newly discovered heart syndrome mimicking acute coronary syndrome has been termed 'Tako-Tsubo cardiomyopathy' (TTC). Differentiation from acute myocardial infarction using the ECG is an important issue in clinical practice.

METHODS:

We retrospectively analyzed patients admitted for cardiac catheterization between September 2003 and September 2006.

RESULTS:

From 26,593 cardiac catheterization procedures, we identified 21 patients with suggested TTC (0.08%). Trigger mechanisms were present in 38.1%; all patients had elevated troponin levels (mean 3.9 ng/ml). Median age was 68.4 years; 90.5% were female. Hypertension was seen in 85.7% and atrial fibrillation in 19.1%. Specific ECG findings related to a TTC are: a mild elevation of the ST segment arising from the S curve of the QRS complex, where the maximum ST segment elevation at the basis of the T wave is <1.5 mm, T-wave inversion, absence of ST segment depression and a summated amplitude of the S curve in V1 plus R in V6 <1.5 mV. An intraventricular gradient was seen in 9.5%; coronary atherosclerosis was detected in 57.1%. Follow-Up Data: Mean follow-up was 13.2 months. 47.6% were free from angina or dyspnea, most of the patients received beta-blockers/ACE inhibitors (76.2%). One patient had a sudden cardiac death (4.8%), 1 patient became an implantable cardioverter-defibrillator primarily due to resuscitation.

CONCLUSION:

TTC is a rare syndrome mimicking acute coronary syndrome that shows a specific ECG pattern and does not appear to be an unambiguously benign disease.

PMID:
18580058
DOI:
10.1159/000137698
[Indexed for MEDLINE]

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