Clinical presentation, treatment, and long term outcomes in patients with takotsubo cardiomyopathy: experience of a single cardiology center

INTRODUCTION: Takotsubo cardiomyopathy (TTC) is a rare transient cardiomyopathy mimicking acute coronary syndrome (ACS). OBJECTIVES: The aim of the study was to retrospectively analyze the clinical course, treatment strategies, and follow up of patients with TTC. PATIENTS AND METHODS: Among all patients hospitalized in the department between January 2005 and January 2010, we identified a group of patients who were fulfilling the modified Mayo Clinic criteria for the diagnosis of TTC. Clinical presentation, hospital course, and clinical outcomes were analyzed. RESULTS: A total of 31 patients with TTC were included into the study; women comprised 93.5% of the study population. The most common symptoms included chest pain and dyspnea caused by emotional or physical stress. Cardiogenic shock was present in 2 subjects and life threatening ventricular arrhythmias in 3 other patients. Twenty four patients had ST segment elevation on the electrocardiogram. A mean left ventricular ejection fraction was 42 ±8.6% during contractility abnormalities, and it increased to 58 ±7.9% during recovery. Troponin I was positive in 30 cases with a mean peak level of 2.7 ±5.1 ng/ml. Follow up data were available in 23 patients and a mean follow up was 955 ±502.8 days. We did not observe a recurrence of TTC. CONCLUSIONS: TTC is observed mainly in postmenopausal women. Clinical presentation of TTC is almost indistinguishable from ACS, but its course is milder and the outcomes are better.