Takotsubo Cardiomyopathy: Healing a Broken Heart
Takotsubo Cardiomyopathy: Healing a Broken Heart
The symptoms of takotsubo cardiomyopathy can mimic those of a myocardial infarction, which can make diagnosis difficult. On admission, many patients have ECG changes (ECG) with an elevated ST segment or T wave inversion similar to a patient having a myocardial infarction. In addition, the patient will frequently have slightly elevated levels of cardiac biomarkers, such as troponin, which points to an acute myocardial infarction.
ECG changes and cardiac biomarker elevations due to takotsubo cardiomyopathy are generally temporary and will return to normal. In our case study, Judy did have slight elevation of her cardiac biomarkers and her ECG showed ST segment elevation, yet all returned to normal as her condition resolved.
It is important to note that a normal ECG is unusual and occurs in only 2% of patients. An echocardiogram may show hypokinesis (as in Judy's case) or akinesis (no movement) of the walls of the left ventricle. The most common finding on the echocardiogram is ballooning or bulging out of the apex of the left ventricle. Patient will often have a reduced ejection fraction, which may lead to heart failure.
Coronary angiography or heart catheterization is an important test in making a differential diagnosis. A patient with myocardial infarction will frequently have blockages in the coronary arteries. A patient with Takotsubo cardiomyopathy will not have any blockages of the coronary arteries.
Differential Diagnosis of Takotsubo Cardiomyopathy Versus Myocardial Infarction
The symptoms of takotsubo cardiomyopathy can mimic those of a myocardial infarction, which can make diagnosis difficult. On admission, many patients have ECG changes (ECG) with an elevated ST segment or T wave inversion similar to a patient having a myocardial infarction. In addition, the patient will frequently have slightly elevated levels of cardiac biomarkers, such as troponin, which points to an acute myocardial infarction.
ECG changes and cardiac biomarker elevations due to takotsubo cardiomyopathy are generally temporary and will return to normal. In our case study, Judy did have slight elevation of her cardiac biomarkers and her ECG showed ST segment elevation, yet all returned to normal as her condition resolved.
It is important to note that a normal ECG is unusual and occurs in only 2% of patients. An echocardiogram may show hypokinesis (as in Judy's case) or akinesis (no movement) of the walls of the left ventricle. The most common finding on the echocardiogram is ballooning or bulging out of the apex of the left ventricle. Patient will often have a reduced ejection fraction, which may lead to heart failure.
Coronary angiography or heart catheterization is an important test in making a differential diagnosis. A patient with myocardial infarction will frequently have blockages in the coronary arteries. A patient with Takotsubo cardiomyopathy will not have any blockages of the coronary arteries.
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