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Takotsubo cardiomyopathy - Stress induced

Posted Jun 24 2009 2:05pm 1 Comment
Watch your stress... you may find yourself suffering from an unusual type of cardiomyopathy (enlargement of the apical aspect of the heart).

(A: Takotsubo Cardiomyopahty scheme with ballooning of the apical aspect of the heart. B: Normal heart cross section)

Takotsubo cardiomyopathy, also known as transient apical ballooning, apical ballooning cardiomyopathy, stress-induced cardiomyopathy, broken-heart-syndrome and simply stress cardiomyopathy, is a type of non-ischemic cardiomyopathy in which there is a sudden temporary weakening of the myocardium (the muscle of the heart). Because this weakening can be triggered by emotional stress, such as the death of a loved one, the condition is also known as broken heart syndrome.

The typical presentation of someone with takotsubo cardiomyopathy is a sudden onset of congestive heart failure or chest pain associated with EKG changes suggestive of an anterior wall heart attack. During the course of evaluation of the patient, a bulging out of the left ventricular apex with a hypercontractile base of the left ventricle is often noted. It is the hallmark bulging out of the apex of the heart with preserved function of the base that earned the syndrome its name "tako tsubo", or octopus trap (bowl) in Japan, where it was first described.

The cause appears to involve high circulating levels of catecholamines (mainly adrenaline/epinephrine). Evaluation of individuals with takotsubo cardiomyopathy typically include a coronary angiogram, which will not reveal any significant blockages that would cause the left ventricular dysfunction. Provided that the individual survives their initial presentation, the left ventricular function improves within 2 months. Takotsubo cardiomyopathy is more commonly seen in post-menopausal women. Often there is a history of a recent severe emotional or physical stress.

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One of the proposed theory regarding the causes of Takotsubo Cardiomyopathy is Wraparound LAD:The LAD (Left Anterior Descending Artery) that supplies blood to the anterior wall of the left ventricle in majority of the patients may wrap around the apex of the heart. Some researchers have found a correlation between takotsubo and this type of LAD that becomes responsible for blood supply to the apex and the inferior wall of the heart. For more visit:

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