Takotsubo-Kardiomyopathie – unterdiagnostiziert?

Abstract

Takotsubo cardiomyopathy (TTC) is a reversible cardiomyopathy that mimics an acute coronary syndrome. It is an important differential diagnosis of an acute myocardial infarction. The precise incidence of TTC is unknown, but most studies have estimated that approximately 1% to 2% of all patients presenting with an initial primary diagnosis of either an acute coronary syndrome or myocardial infarction have TTC. Consequently the syndrome is underrecognized and often misdiagnosed. We review the reasons for the under-diagnosis of TTC including the novel nature of the disease especially for non-cardiologists, varied presentations (e.g. different ballooning patterns), and diagnostic uncertainty in patients with mild coronary artery disease and/or without a stressful trigger before the acute onset of the syndrome.

• Literatur

• 1 Bybee KA, Kara T, Prasad A et al. Systematic review: transient left ventricular apical ballooning: a syndrome that mimics ST-segment elevation myocardial infarction. Ann Intern Med 2004; 141: 858-865
• 2 Gianni M, Dentali F, Grandi AM et al. Apical ballooning syndrome or takotsubo cardiomyopathy: a systematic review. Eur Heart J 2006; 27: 1523-1529
• 3 Prasad A, Lerman A, Rihal CS. Apical ballooning syndrome (Tako-Tsubo or stress cardiomyopathy): a mimic of acute myocardial infarction. Am Heart J 2008; 155: 408-417
• 4 Pilgrim TM, Wyss TR. Takotsubo cardiomyopathy or transient left ventricular apical ballooning syndrome: A systematic review. Int J Cardiol 2008; 124: 283-292
• 5 Dote K, Sato H, Tateishi H et al. Myocardial stunning due to simultaneous multivessel coronary spasms: a review of 5 cases. J Cardiol 1991; 21: 203-214
• 6 Eitel I, Behrendt F, Schindler K et al. Differential diagnosis of suspected apical ballooning syndrome using contrast-enhanced magnetic resonance imaging. Eur Heart J 2008; 29: 2651-2659
• 7 Eitel I, von Knobelsdorff-Brenkenhoff F, Bernhardt P et al. Clinical characteristics and cardiovascular magnetic resonance findings in stress (takotsubo) cardiomyopathy. JAMA 2011; 306: 277-286
• 8 Madhavan M, Prasad A. Proposed Mayo Clinic criteria for the diagnosis of Tako-Tsubo cardiomyopathy and long-term prognosis. Herz 2010; 35: 240-243
• 9 Wedekind H, Moller K, Scholz KH. Tako-tsubo cardiomyopathy. Incidence in patients with acute coronary syndrome. Herz 2006; 31: 339-346
• 10 Kurowski V, Kaiser A, von Hof K. Apical and midventricular transient left ventricular dysfunction syndrome (tako-tsubo cardiomyopathy): frequency, mechanisms, and prognosis. Chest 2007; 132: 809-816
• 11 Eitel I, Schuler G, Gutberlet M et al. Biventricular stress-induced (takotsubo) cardiomyopathy with left midventricular and right apical ballooning. Int J Cardiol 2011; 151: e63-64
• 12 Eitel I, Lucke C, Behrendt F et al. Full recovery of Takotsubo cardiomyopathy (apical ballooning) in two days. Int J Cardiol 2010; 143: e51-e53