Takotsubo cardiomyopathy: Nursing a broken heart
Nichole Pore MSN, ACNP-BC
Michael Burley MD, FACC

December 2012 
Volume 42  Number 12
Pages 50 - 54
  PDF Version Available!

EXTREME TRAUMATIZING EVENTS and stressful situations such as the loss of a loved one really can cause a broken heart: Takotsubo cardiomyopathy, a rare but reversible form of cardiomyopathy. The syndrome takes its name from the Japanese words for a fishing pot (tsubo) used to catch octopus (tako) because the shape of the left ventricle resembles the pot's round bottom and narrow neck. Left ventricular (LV) dysfunction in takotsubo cardiomyopathy is characterized by dyskinesis of the apex and hyperkinesis of the base.Also called transient apical ballooning or stress cardiomyopathy, takotsubo cardiomyopathy often mimics the signs and symptoms of acute coronary syndromes (ACS). Differentiating the causes is important because treatment strategies are different. However, with proper treatment, patients have a good prognosis and LV function is generally restored within days to weeks.1This article discusses the pathophysiology, clinical manifestations, diagnosis, and treatment of takotsubo cardiomyopathy.Most (90%) patients with takotsubo cardiomyopathy are women, with postmenopausal women affected more often than other women. Some researchers hypothesize that certain women have an exaggerated physiologic response to stress, either through an increased release of catecholamines or unusual sensitivity to catecholamines. Postmenopausal women may be particularly vulnerable because they have lower levels of cardioprotective estrogen.2,3Others at risk for takotsubo cardiomyopathy include patients experiencing acute medical illness, acute intracranial events, surgical procedures, or exposure to high levels of endogenous or exogenous catecholamines.4 Although takotsubo cardiomyopathy has been reported more often in adults, it's also been diagnosed in patients as young as 17. An estimated 1% to 2% of all myocardial infarctions (MIs) are related to takotsubo cardiomyopathy.3The exact cause of takotsubo cardiomyopathy isn't known, but the primary theory is that the syndrome is triggered

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