Differences in ST-elevation and T-wave amplitudes do not reliably differentiate takotsubo cardiomyopathy from acute anterior myocardial infarction

Parkkonen, Olavi; Allonen, Jaakko; Vaara, Satu; Viitasalo, Matti; Nieminen, Markku S.; Sinisalo, Juha

doi:10.1016/j.jelectrocard.2014.06.006

Cited by 40 publications

(33 citation statements)

References 17 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…In the literature, there is a significant variability in the reported frequency of ST elevation upon presentation, ranging from 34% to 100%. 4,12 In contrast, in our study, seven patients presented with ST elevation in V 1 (two AA and five non-AA). 10 Two studies reported that a lack of ST elevation in V 1 and ST-depression in aVR distinguished TC from STEMI.…”

Section: Aa Patients Have Less St Depression Oncontrasting

confidence: 72%

Distinctive Electrocardiographic Features in African Americans Diagnosed with Takotsubo Cardiomyopathy

Franco

Dias

Koshkelashvili

et al. 2016

Noninvasive Electrocardiol

View full text Add to dashboard Cite

show abstract

Section: Aa Patients Have Less St Depression Oncontrasting

confidence: 72%

Distinctive Electrocardiographic Features in African Americans Diagnosed with Takotsubo Cardiomyopathy

Franco

Dias

Koshkelashvili

et al. 2016

Noninvasive Electrocardiol

View full text Add to dashboard Cite

show abstract

“…Although the ability of ECG to reliably differentiate TTC from MI was questioned in some studies, our data showed that ECG criteria could in fact distinguish between the 2 entities. In our study, when ST‐elevation was present in TTC patients, its distribution differed widely, which was consistent with previous studies . In fact, in TTC, ST‐elevation was diffusely prevalent, particularly in anteroseptal and anterior leads, and occurred more in commonly in –aVR.…”

Section: Discussionmentioning

confidence: 71%

“…ECG criteria for the differential diagnosis of TTC proposed in previously published studies are summarized in Table . The results of re‐analysis of the same criteria with the same subgroups of patients from our data are also given in the table.…”

Section: Discussionmentioning

confidence: 99%

ECG Criteria to Differentiate Between Takotsubo (Stress) Cardiomyopathy and Myocardial Infarction

Frangieh

Obeid

Ghadri

et al. 2016

JAHA

130

110

View full text Add to dashboard Cite

BackgroundECG criteria differentiating Takotsubo cardiomyopathy (TTC) from mainly anterior myocardial infarction (MI) have been suggested; however, this was in small patient populations.Methods and ResultsTwelve‐lead admission ECGs of consecutive 200 TTC and 200 MI patients were compared in dichotomized groups based on the presence or absence of ST‐elevation MI (STEMI versus STE‐TTC and non‐ST elevation MI versus non ST‐elevation‐TTC). When comparing STEMI and STE‐TTC, ST‐elevation in –aVR was characteristic of STE‐TTC with a sensitivity/specificity of 43% and 95%, positive predictive value (PPV) 91%, and a negative predictive value (NPV) 62% (P<0.001); when ST‐elevation in –aVR is accompanied by ST‐elevation in inferior leads, sensitivity/specificity were 14% and 98% (PPV was 89% and NPV 52%) (P=0.001), and 12% and 100% when associated with ST‐elevation in anteroseptal leads (PPV 100%, NPV 52%) (P<0.001). On the other hand, STEMI was characterized by ST‐elevation in aVR (sensitivity/specificity of 31% and 95% P<0.001, PPV 85% and NPV 59%) and ST‐depression in V2‐V3‐V4 (sensitivity/specificity of 24% and 100% P<0.001, PPV 100% and NPV 76%). When comparing non‐ST elevation MI and non ST‐elevation‐TTC, T‐inversion in leads I‐aVL‐V5‐V6 had a sensitivity/specificity of 17% and 97% for non ST‐elevation‐TTC (PPV 83% and NPV 55%) (P<0.001), and ST‐elevation in –aVR with T‐inversion in any lead was also specific for non ST‐elevation‐TTC (sensitivity/specificity of 8% and 100%, PPV 100% and NPV 53%) (P=0.006). In non‐ST elevation MI patients, the presence of ST‐depression in V2‐V3 was specific (sensitivity/specificity of 11% and 99%, PPV 91% and NPV 51%) (P=0.01).ConclusionsECG on admission can differentiate between TTC and acute MI, with high specificity and positive predictive value.Clinical Trial RegistrationURL: https://www.clinicaltrials.gov/. Unique identifier: NCT01947621.

show abstract

“…The Mayo Clinic diagnostic criteria can be used to diagnose TCM. All four of these criteria are required for the diagnosis:3 7 first: transient left ventricular systolic dysfunction with wall motion abnormalities that extend beyond the distribution of a single coronary artery,7 second: absence of obstructive coronary artery disease or acute plaque rupture, third: new ECG abnormalities or elevated cardiac troponins, and6 17 18 fourth: absence of pheochromocytoma or myocarditis.…”

Section: Discussionmentioning

confidence: 99%

Takotsubo cardiomyopathy secondary to spontaneous right-sided pneumothorax

Bhardwaj

et al. 2017

BMJ Case Reports

View full text Add to dashboard Cite

Takotsubo cardiomyopathy (TCM) is a unique type of cardiomyopathy characterised by left ventricular systolic dysfunction in association with stressful conditions. Patients with this condition usually present with chest pain and dyspnoea, and the presentation can mimic acute coronary syndrome. We present a case of a woman aged 58 years who presented with progressive dyspnoea and cough. Her initial evaluation was suggestive of acute myocardial infarction with elevated serum troponin T and ST segment elevation. Her chest radiograph showed a large right-sided pneumothorax, which was treated with chest tube insertion. Coronary angiography and echocardiogram did not show any evidence of obstructive coronary artery disease but did show a large area of akinesis consistent with TCM. The patient was managed medically with supportive care. Her pneumothorax resolved, and her follow-up echocardiogram also showed improvement. The association between pneumothorax and TCM is rare, and only four other cases have been reported so far in the English literature.

show abstract

Differences in ST-elevation and T-wave amplitudes do not reliably differentiate takotsubo cardiomyopathy from acute anterior myocardial infarction

Cited by 40 publications

References 17 publications

Distinctive Electrocardiographic Features in African Americans Diagnosed with Takotsubo Cardiomyopathy

Distinctive Electrocardiographic Features in African Americans Diagnosed with Takotsubo Cardiomyopathy

ECG Criteria to Differentiate Between Takotsubo (Stress) Cardiomyopathy and Myocardial Infarction

Takotsubo cardiomyopathy secondary to spontaneous right-sided pneumothorax

Contact Info

Product

Resources

About