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Takotsubo cardiomyopathy (broken-heart syndrome) in differential diagnosis of chest pain
Takotsubo cardiomyopathy (also called stress induced cardiomyopathy, apical ballooning, or broken heart syndrome) was first described in Japan 20 years ago. It is typically precipitated by acute emotional stress, hence the names “stress cardiomyopathy” or “broken-heart syndrome.”
Takotsubo cardiomyopathy is characterised by acute, reversible left ventricular dysfunction in a distribution,which does not correlate with the coronary artery blood supply. The left ventricular dysfunction occurs without obstructive coronary artery disease (CAD) and usually resolves spontaneously over a period of weeks.
The characteristic appearances on contrast angiography include:
Although Takotsubo cardiomyopathy was initially considered rare, it could possibly be responsible for 1-2% of admissions for acute coronary syndrome in industrialised countries.
Takotsubo cardiomyopathy. Banning et al. 340: c1272, BMJ.
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