A systematic review on focal takotsubo syndrome: a not-so-small matter

AbstractA focal contraction pattern in takotsubo syndrome (TTS) is considered rare. Due to its peculiar presentation, which includes segmental left ventricular (LV) regional wall motion abnormalities (RWMA), the focal TTS pattern may be hardly differentiable from other entities, such as myocarditis or myocardial infarction. We performed a comprehensive systematic literature review researching for works in English published in Journals indexed in Embase, available online for consultation, using the following keywords (in Title and/or Abstract): ( “takotsubo” OR “broken heart” OR “apical ballooning” OR “stress cardiomyopathy”) AND (“focal” OR “atypical” OR “variant” OR “segments”). Thirty-three papers were retrieved: 17 case reports, 6 case series, and 10 population studies—with a total of 166 focal TTS patie nts. Prevalence of focal TTS ranged between 0.1% and 14% (pooled mean: 2.8%). Mean age of onset (58 years), gender distribution (80% of females), and type of triggers appeared similar to those reported in typical TTS. RWMA more frequently involved the interventricular septum and the anterolateral L V segments, with often preserved LV ejection fraction. In the majority of focal TTS reports that included adequate ECG information (n = 13), abnormalities were localized and not diffuse, always matching RWMA, and in 3 cases, reciprocal changes were observed. No in-hospital nor long-term deaths were reported. The focal TTS contraction patter...
Source: Heart Failure Reviews - Category: Cardiology Source Type: research