학술논문
Our clinical experience and case series of Takotsubo cardiomyopathy/ Takotsubo kardiyomiyopati uzerine klinik deneyimimiz ve vaka serimiz
Case Report
Case Report
Document Type
Academic Journal
Source
Pamukkale Medical Journal. January 2023, Vol. 16 Issue 1, p149, 7 p.
Subject
Language
English
ISSN
1309-9833
Abstract
Introduction Takotsubo Cardiomyopathy (TC) was first described in 1990 by Dote et al. [1]. The reason why it is called tako-tsubo cardiomyopathy; This is because the appearance of the left [...]
In this study we aimed to evaluate the clinical course and prognosis of Takotsubo Cardiomyopathy cases diagnosed and treated in our clinic. Takotsubo Cardiomyopathy was first described in 1990 by Dote et al. The reason why it is called Tako-tsubo cardiomyopathy; This is due to the appearance of the left ventricle resembling the narrow-necked, broad-bottomed container used by Japanese fishermen to catch octopuses. In addition to Takotsubo cardiomyopathy, this syndrome is also called ampulla cardiomyopathy, Human stress cardiomyopathy and Broken heart syndrome. In this study, a series of 7 cases of Takotsubo Cardiomyopathy diagnosed and treated in our clinic are presented and the clinical course and prognosis of the disease are examined. The age range of the series, consisting of six female and one male patients, ranged from 57 to 81 years (median age 70). All of the female patients were in the postmenopausal period and physical or emotional stress was found in four of them. Moderate-to-moderate cardiac enzyme elevation was found in all of the patients. While noncritical plaques were detected in the angiography of six patients who underwent coronary angiography and ventriculography, one patient had normal coronaries. During the follow-up, in-hospital death due to non-cardiac causes (Acute Myeloblastic Leukemia) was observed in one of the patients. In the echocardiographic follow-up of six surviving patients, it was observed that the LV ejection fraction was normalized and ballooning regressed within two months. The awareness of Takotsubo Cardiomyopathy among cardiology physicians in the world and in our country is increasing. However, information about its prevalence, clinical course and short-term prognosis in our country is insufficient. In the study, a new series was presented in addition to the first data of our country. It is thought that there may be some different physical risk factors that have not yet been identified. Key words: Acute myocardial infarction, emotinal stress, takotsubo cardiomyopathy. Bu calismada klinigimizde teshis ve tedavi edilen Takotsubo Kardiyomiyopati olgularinin klinik seyrini ve prognozunu degerlendirmeyi amacladik. Takotsubo Kardiyomiyopati ilk olarak 1990 yilinda Dote ve ark. Tako-tsubo kardiyomiyopati olarak adlandirilmasinin nedeni; sol ventrikulun gorunusunun, Japon balikcilarinin ahtapot yakalamak icin kullandigi dar boyunlu, genis tabanli kaba benzemesinden dolayidir. Bu sendroma Takotsubo kardiyomiyopatisinin yani sira ampulla kardiyomiyopatisi, insan stres kardiyomiyopatisi ve kirik kalp sendromu da denir. Bu calismada klinigimizde teshis ve tedavi edilen 7 Takotsubo Kardiyomiyopati olgusu sunulmakta ve hastaligin klinik seyri ve prognozu incelenmektedir. Alti kadin ve bir erkek hastadan olusan serinin yas araligi 57 ile 81 yil (ortalama yas 70) arasinda degismekteydi. Kadin hastalarin tamami postmenopozal donemdeydi ve dordunde fiziksel veya emosyonel stres saptandi. Tum hastalarda orta-orta duzeyde kardiyak enzim yuksekligi saptandi. Koroner anjiyografi ve ventrikulografi yapilan alti hastanin anjiyografisinde kritik olmayan plaklar tespit edilirken, bir hastada koroner arterler normaldi. Takiplerde hastalardan birinde kalp disi nedenlere bagli hastane ici olum (Akut Miyeloblastik Losemi) gozlendi. Yasayan alti hastanin ekokardiyografik takibinde iki ay icinde LV ejeksiyon fraksiyonunun normale dondugu ve balonlasmanin geriledigi goruldu. Dunyada ve ulkemizde kardiyoloji hekimleri arasinda Takotsubo Kardiyomiyopati farkindaligi giderek artmaktadir. Ancak ulkemizde prevalansi, klinik seyri ve kisa donem prognozu ile ilgili bilgiler yetersizdir. Calismada ulkemizin ilk verilerine ek olarak yeni bir seri sunulmustur. Henuz tanimlanmamis bazi farkli fiziksel risk faktorlerinin olabilecegi dusunulmektedir. Anahtar kelimeler: Akut miyokard enfarktusu, duygusal stres, takotsubo kardiyomiyopati.
In this study we aimed to evaluate the clinical course and prognosis of Takotsubo Cardiomyopathy cases diagnosed and treated in our clinic. Takotsubo Cardiomyopathy was first described in 1990 by Dote et al. The reason why it is called Tako-tsubo cardiomyopathy; This is due to the appearance of the left ventricle resembling the narrow-necked, broad-bottomed container used by Japanese fishermen to catch octopuses. In addition to Takotsubo cardiomyopathy, this syndrome is also called ampulla cardiomyopathy, Human stress cardiomyopathy and Broken heart syndrome. In this study, a series of 7 cases of Takotsubo Cardiomyopathy diagnosed and treated in our clinic are presented and the clinical course and prognosis of the disease are examined. The age range of the series, consisting of six female and one male patients, ranged from 57 to 81 years (median age 70). All of the female patients were in the postmenopausal period and physical or emotional stress was found in four of them. Moderate-to-moderate cardiac enzyme elevation was found in all of the patients. While noncritical plaques were detected in the angiography of six patients who underwent coronary angiography and ventriculography, one patient had normal coronaries. During the follow-up, in-hospital death due to non-cardiac causes (Acute Myeloblastic Leukemia) was observed in one of the patients. In the echocardiographic follow-up of six surviving patients, it was observed that the LV ejection fraction was normalized and ballooning regressed within two months. The awareness of Takotsubo Cardiomyopathy among cardiology physicians in the world and in our country is increasing. However, information about its prevalence, clinical course and short-term prognosis in our country is insufficient. In the study, a new series was presented in addition to the first data of our country. It is thought that there may be some different physical risk factors that have not yet been identified. Key words: Acute myocardial infarction, emotinal stress, takotsubo cardiomyopathy. Bu calismada klinigimizde teshis ve tedavi edilen Takotsubo Kardiyomiyopati olgularinin klinik seyrini ve prognozunu degerlendirmeyi amacladik. Takotsubo Kardiyomiyopati ilk olarak 1990 yilinda Dote ve ark. Tako-tsubo kardiyomiyopati olarak adlandirilmasinin nedeni; sol ventrikulun gorunusunun, Japon balikcilarinin ahtapot yakalamak icin kullandigi dar boyunlu, genis tabanli kaba benzemesinden dolayidir. Bu sendroma Takotsubo kardiyomiyopatisinin yani sira ampulla kardiyomiyopatisi, insan stres kardiyomiyopatisi ve kirik kalp sendromu da denir. Bu calismada klinigimizde teshis ve tedavi edilen 7 Takotsubo Kardiyomiyopati olgusu sunulmakta ve hastaligin klinik seyri ve prognozu incelenmektedir. Alti kadin ve bir erkek hastadan olusan serinin yas araligi 57 ile 81 yil (ortalama yas 70) arasinda degismekteydi. Kadin hastalarin tamami postmenopozal donemdeydi ve dordunde fiziksel veya emosyonel stres saptandi. Tum hastalarda orta-orta duzeyde kardiyak enzim yuksekligi saptandi. Koroner anjiyografi ve ventrikulografi yapilan alti hastanin anjiyografisinde kritik olmayan plaklar tespit edilirken, bir hastada koroner arterler normaldi. Takiplerde hastalardan birinde kalp disi nedenlere bagli hastane ici olum (Akut Miyeloblastik Losemi) gozlendi. Yasayan alti hastanin ekokardiyografik takibinde iki ay icinde LV ejeksiyon fraksiyonunun normale dondugu ve balonlasmanin geriledigi goruldu. Dunyada ve ulkemizde kardiyoloji hekimleri arasinda Takotsubo Kardiyomiyopati farkindaligi giderek artmaktadir. Ancak ulkemizde prevalansi, klinik seyri ve kisa donem prognozu ile ilgili bilgiler yetersizdir. Calismada ulkemizin ilk verilerine ek olarak yeni bir seri sunulmustur. Henuz tanimlanmamis bazi farkli fiziksel risk faktorlerinin olabilecegi dusunulmektedir. Anahtar kelimeler: Akut miyokard enfarktusu, duygusal stres, takotsubo kardiyomiyopati.