Takotsubo cardiomyopathy or “broken heart syndrome” – A case report
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Cardiovascular Intensive Care Unit of Provincial Specialist Hospital in Olsztyn, Faculty of Medical Sciences, University of Warmia and Mazury in Olsztyn, Poland
Damian Wojno   

Burskiego 28/4, 10-686 Olsztyn, Poland. Tel.: +48 517 474 633.
Submission date: 2013-05-05
Acceptance date: 2013-09-15
Online publication date: 2013-09-20
Publication date: 2020-04-08
Pol. Ann. Med. 2013;20(2):128–131
Takotsubo cardiomyopathy (TTC) is an interesting syndrome and one of the essential elements of differential diagnosis of acute coronary syndromes. This disease entity is very rare and was first described in 1991.

The aim of this study is to present the disease entity of TCC, its diagnostic criteria and necessity for including it in the differential diagnosis of acute coronary syndromes.

Material and methods:
Case report and analysis of a case of a 74-year-old patient with TTC.

Case study:
Female patient, 74 years of age, was admitted to Cardiovascular Intensive Care Unit of Provincial Specialist Hospital in Olsztyn due to severe, acute chest pain that occurred after the death of her husband.

Results and discussion:
TTC currently accounts for approximately 2% of initially diagnosed acute coronary syndromes. The etiology of TTC is not fully understood. Main clinical symptoms include severe, acute chest pain of sudden onset. Typically it occurs most frequently after a stressful situation, such as e.g. death of a loved one, serious surgical procedure or traffic accident. Characteristics also include changes in cardiac imaging studies (echocardiography) in the form of apical akinesis or hypokinesis, electrocardiographic abnormalities (ECG) presenting with ST-segment elevation in the anterior, lateral and inferior leads, as well as non-specific elevation of serum cardiac markers suggestive of myocardial injury. Coronary angiography does not reveal any coronary blockages. The proposed Mayo Clinic diagnostic criteria are useful for the diagnosis of the disease.

Similar clinical presentation and ECG changes indicate that this syndrome should be differentiated from ACS, particularly in atypical cases.

None declared.
Bertrand ME, King III SB. Ostre zespoły wieńcowe [Acute Coronary Syndromes]. Warszawa: Medipage; 2007.
Bybee KA, Kara T, Prasad A, Lerman A, Barsness GW, Wright RS, et al. Systematic review: transient left ventricular apical ballooning: a syndrome that mimics ST-segment elevation myocardial infarction. Ann Intern Med. 2004;141(11):858–865.
Grabowski M, Karpiński G, Kochman J, Kochanowski J, Piątkowski R, Scisło P, et al. Zespół balotującego koniuszka u 57-letniej chorej w trakcie premedykacji do znieczulenia ogólnego [Apical ballooning syndrome in a 57-year-old woman during premedication for general anaesthesia]. Kardiol Pol. 2006;64:1110–1112 [in Polish].
Koulouris S, Pastromas S, Sakellariou D, Kratimenos T, Piperopoulos P, Manolis A. Takotsubo cardiomyopathy: the “broken heart” syndrome. Hellenic J Cardiol. 2010;51(5):451–457.
Kurisu S, Sato H, Kawagoe T, Ishihara M, Shimatani Y, Nishioka K, et al. Tako-tsubo-like left ventricular dysfunction with ST-segment elevation: a novel cardiac syndrome mimicking acute myocardial infarction. Am Heart J. 2002;143(3):448–455.
Lateef F. The “broken heart sydrome”: you're likely to have it only once!. Singapore Med J. 2010;51(4):76.
Michalak M, Huczek Z. Kardiomiopatia tako-tsubo – obecny stan wiedzy [Takotsubo cardiomyopathy – current state of knowledge]. Pol Przegl Kardiol. 2008;10(4):308–312.
Rozwodowska M, Łukasiewicz A, Sukiennik A, Świątkiewicz I, Rychter M, Kubica J. Kardiomiopatia tako-tsubo – problem kliniczny [Takotsubo cardiomyopathy – a clinical problem]. Folia Cardiol Excerpta. 2010;5(5):298–304.
Sato H, Tateishi H, Uchida T, Dote K, Ishihara M. Tako-tsubo-like left ventricular dysfunction due to multivessel coronary spasm. In: Kodama K, Haze K, Hori M, eds. Clinical Aspect of Myocardial Injury: From Ischemia to Heart Failure.Tokio; 1990:56 – 64 [in Japanese].
Schoof S, Bertram H, Hohmann D, Jack T, Wessel A, Yelbuz M. Tako- tsubo cardiomyopathy in a 2-year-old girl. J. Am. Coll. Cardiol. 2010;55(3):5.
Sealove B, Tiyyagura S, Fuster V. Takotsubo cardiomyopathy. J Gen Intern Med. 2008;23(11):1904–1908.
Suchcicki W, Łada M, Karwowski D, Noll K. Kardiomiopatia tako-tsubo – opis przypadku oraz przegląd piśmiennictwa [Takotsubo cardiomyopathy – a case report and literature review]. Post Kardiol Interw. 2007;3(4):227–234.
Wittstein IS, Thiemann DR, Lima JA, Baughman K, Schulman S, Gerstenblith G, et al. Neurohumoral features of myocardial stunning due to sudden emotional stress. N Engl J Med. 2005;352:539–548.