Takotsubo Disease

Abstract

Tako-tsubo cardiomyopathy, a novel heart syndrome with peculiar variant of left ventricular dysfunction,
characterized by preferential apical dyskinesis and basal hyper contractility has been described on
numerous occasions especially in persons without obstructive coronary artery disease. It is considered of
reversible etiology and seems to have increased predisposition in elderly, stress-ridden females. Although
Tako-tsubo cardiomyopathy was described initially in patients of Japanese origin, its existence in white
populations in both Europe and the US have recently been documented. Simultaneous multivessel
coronary spasm of the epicardial coronary microvessels is believed to be a major contributor. However,
this pathophysiologic basis for this phenomenon has not been validated universally throughout literature.
Another potential mechanism of events that seems to be responsible for this phenomenon is the transient
myocardial stunning associated with hypersensitivity to catecholamine. The clinical presentation usually
simulates that of an acute ST- elevated myocardial infarction but the coronary angiography by definition
shows no critical lesions. Patients surviving acute episode usually recover fully in few weeks. Acute onset
of cardiogenic shock in a person without coronary risk factors should raise the possibility of this rare type
of entity but should not withhold the acute treatment. Prognosis generally varies and has largely been
good. Takotsubo though largely benign may be fatal sometimes.
Key Words: Takotsubo disease, stress induced cardiomyopathy, normal coronary.