Diagnostic challenges between takotsubo cardiomyopathy and acute myocardial infarction—where is the emergency?: a literature review
Dublin Core
Title
Diagnostic challenges between takotsubo cardiomyopathy and acute myocardial infarction—where is the emergency?: a literature review
Subject
Takotsubo cardiomyopathy, Acute myocardial infarction, Echocardiography, Therapeutic strategy, Prognosis
Description
Background Takotsubo cardiomyopathy (TC) is an emergency cardiovascular disease, with clinical and paraclinical
manifestations similar to acute myocardial infarction (AMI), but it is characterized by reversible systolic dysfunction
of the left ventricle (LV) in the absence (most of the time) of obstructive coronary artery disease (CAD).
Management of patients with TC TC seems to be more frequent in post-menopausal women and it is triggered
by emotional or physical stress. The diagnosis of TC is based on the Mayo Clinic criteria. Initially, patients with TC
should be treated as those with AMI and carefully monitored in intensive care unit. Urgent clinical and paraclinical
distinction between TC and AMI is mandatory in all patients, because of the different therapeutical management
between the two diseases. Chest pain and dyspnea are the most common symptoms in TC. Paraclinical diagno‐
sis is based on cardiac biomarkers, electrocardiogram (ST-segment elevation/T wave inversion in precordial leads
without reciprocal ST-segment depression in inferior leads and absence of Q waves), echocardiography (LV systolic
dysfunction, regional wall motion abnormalities extended in more than one coronary territory), cardiac magnetic
resonance and in most of the cases the positive diagnosis is established by performing CA to exclude obstructive
CAD. The prognosis of patients with TC is considered benign in most cases, with a complete LV function recovery,
but severe complications may occur, such as cardiogenic shock, LV free wall rupture, life-threatening arrhythmia,
and cardiac arrest. Postoperative TC may develop after any type of surgical intervention due to acute stress and it
should be differentiated from postoperative AMI. The management of patients with TC is medical and it is based
on supportive care and the treatment of heart failure, while patients with AMI require myocardial revascularization.
Conclusions TC leads to transient LV dysfunction that mimics AMI from which it should be differentiated for a good
therapeutic approach. Patients with TC should be carefully monitored during hospitalization because they have a high
recovery potential if optimally treated.
Keywords Takotsubo cardiomyopathy, Acute myocardial infarction, Echocardiography, Therapeutic strategy,
Prognosis
manifestations similar to acute myocardial infarction (AMI), but it is characterized by reversible systolic dysfunction
of the left ventricle (LV) in the absence (most of the time) of obstructive coronary artery disease (CAD).
Management of patients with TC TC seems to be more frequent in post-menopausal women and it is triggered
by emotional or physical stress. The diagnosis of TC is based on the Mayo Clinic criteria. Initially, patients with TC
should be treated as those with AMI and carefully monitored in intensive care unit. Urgent clinical and paraclinical
distinction between TC and AMI is mandatory in all patients, because of the different therapeutical management
between the two diseases. Chest pain and dyspnea are the most common symptoms in TC. Paraclinical diagno‐
sis is based on cardiac biomarkers, electrocardiogram (ST-segment elevation/T wave inversion in precordial leads
without reciprocal ST-segment depression in inferior leads and absence of Q waves), echocardiography (LV systolic
dysfunction, regional wall motion abnormalities extended in more than one coronary territory), cardiac magnetic
resonance and in most of the cases the positive diagnosis is established by performing CA to exclude obstructive
CAD. The prognosis of patients with TC is considered benign in most cases, with a complete LV function recovery,
but severe complications may occur, such as cardiogenic shock, LV free wall rupture, life-threatening arrhythmia,
and cardiac arrest. Postoperative TC may develop after any type of surgical intervention due to acute stress and it
should be differentiated from postoperative AMI. The management of patients with TC is medical and it is based
on supportive care and the treatment of heart failure, while patients with AMI require myocardial revascularization.
Conclusions TC leads to transient LV dysfunction that mimics AMI from which it should be differentiated for a good
therapeutic approach. Patients with TC should be carefully monitored during hospitalization because they have a high
recovery potential if optimally treated.
Keywords Takotsubo cardiomyopathy, Acute myocardial infarction, Echocardiography, Therapeutic strategy,
Prognosis
Creator
Alexandru Scafa‐Udriste1,2, Ruxandra‐Nicoleta Horodinschi1,2*, Miruna Babos3 and Bogdan Dinu1,3
Source
https://doi.org/10.1186/s12245-024-00595-4
Date
2024
Contributor
Peri Irawan
Format
pdf
Language
english
Type
text
Files
Collection
Citation
Alexandru Scafa‐Udriste1,2, Ruxandra‐Nicoleta Horodinschi1,2*, Miruna Babos3 and Bogdan Dinu1,3, “Diagnostic challenges between takotsubo cardiomyopathy and acute myocardial infarction—where is the emergency?: a literature review,” Repository Horizon University Indonesia, accessed April 11, 2026, https://repository.horizon.ac.id/items/show/12277.