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dc.contributor.author Popa, Carolina
dc.date.accessioned 2022-02-10T09:50:32Z
dc.date.available 2022-02-10T09:50:32Z
dc.date.issued 2010
dc.identifier.citation POPA, Carolina. Study review: Tako Tsubo syndrome. In: MedEspera: the 3rd Internat. Medical Congress for Students and Young Doctors: abstract book. Chișinău: S. n., 2010, pp. 58-59. en_US
dc.identifier.uri http://repository.usmf.md/handle/20.500.12710/20063
dc.description.abstract Tako-Tsubo cardiomyopathy is characterised by an atypical distribution of left ventricular (LV) dysynergy with apical ballooning and compensatory basal hyperkinesis. Coronary angiography is normal. Several substrates have been put forward to explain the underlying pathophysiology such as raised catecholamine levels (due to physical or emotional stress), multivessel epicardial coronary spasm or diffuse microvascular spasm. However, the pathophysiology has not yet been fully clarified. We present a series of cases whose findings could explain the mechanism underlying this syndrome. Four consecutives patients, all female, were admitted with the clinical features typical of Tako-Tsubo syndrome. In all, severe widespread transient LV mid-apical a/dyskinesia was associated with a midcavity dynamic obstruction which resolved prior to the resolution of the LV wall motion abnormalities. In all cases the dynamic LV obstruction was related to localise mid-ventricular septal thickening. After improvement in wall motion, a low-dose strain/strain rate dobutamine stressechocardiography (DSE) was performed to determine the underlying ischaemic substrate. This provoked an LV mid-cavity gradient at peak dose in all. Regional deformation changes during DSE showed the affected myocardium to have the typical response diagnostic of regional stunning. We postulate that an important unrecognised factor in the development of Tako-Tsubo cardiomyopathy is the presence of abnormal myocardial functional architecture (such as localised mid-ventricular septal thickening), which in the presence of dehydration and/or raised catecholamine levels due to physical or emotional stress, leads the development of a severe transient LV mid-cavity obstruction. This effectively sub-divides the LV into two functionally different chambers with a marked increase in wall stress in the high pressure distal apical chamber. This, in combination with the abnormal high circulating catecholamine levels, induces widespread sub-endocardial ischaemia which is unrelated to a specific coronary artery territory. With rehydration/fall in catecholamine levels the interventricular gradient resolves and distal function recovers. Low dose SR/S DSE confirms that the distal ischaemic substrate is myocardial stunning. en_US
dc.language.iso en en_US
dc.publisher Nicolae Testemitanu State Medical and Pharmaceutical University en_US
dc.relation.ispartof MedEspera: The 3rd International Medical Congress for Students and Young Doctors, May 19-21, 2010, Chisinau, Republic of Moldova en_US
dc.title Study review: Tako Tsubo syndrome en_US
dc.type Other en_US


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    The 3rd International Medical Congress for Students and Young Doctors, May 19-21, 2010

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