Mechanical Circulatory Support Strategies in Takotsubo Syndrome with Cardiogenic Shock: A Systematic Review

von Mackensen, Johanna K. R.; Zwaans, Vanessa I. T.; El Shazly, Ahmed; Van Praet, Karel M.; Heck, Roland; Starck, Christoph T.; Schoenrath, Felix; Potapov, Evgenij V.; Kempfert, Joerg; Jacobs, Stephan; Falk, Volkmar; Wert, Leonhard

doi:10.3390/jcm13020473

Cited by 2 publications

(1 citation statement)

References 75 publications

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“…The timing of implantation and weaning is also not clear in this population. In 2024, Von Mackensen et al published a systematic review on the use of MCS for TTS patients [ 80 ]. The authors included 93 articles from 124 patients; 50% were treated with veno-arterial extracorporeal membrane oxygenation (VA-ECMO), 36% received a left ventricular assist device (e.i.…”

Section: Treatment and Postoperative Carementioning

confidence: 99%

Perioperative management of Takotsubo cardiomyopathy: an overview

Pillitteri,

Brogi,

Piagnani

et al. 2024

J Anesth Analg Crit Care

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Resembling the morphology of Japanese polyp vessels, the classic form of Takotsubo cardiomyopathy is characterized by the presence of systolic dysfunction of the mid-apical portion of the left ventricle associated with basal hyperkinesia. It is believed that this may be due to a higher density of β-adrenergic receptors in the context of the apical myocardium, which could explain the greater sensitivity of the apex to fluctuations in catecholamine levels.The syndrome is precipitated by significant emotional stress or acute severe pathologies, and it is increasingly diagnosed during the perioperative period. Indeed, surgery, induction of general anaesthesia and critical illness represent potential harmful trigger of stress cardiomyopathy. No universally accepted guidelines are currently available, and, generally, the treatment of TTS relies on health care personal experience and/or local practice. In our daily practice, anaesthesiologists can be asked to manage patients with the diagnosis of new-onset Takotsubo before elective surgery or an emergent surgery in a patient with a concomitant stress cardiomyopathy. Even more, stress cardiomyopathy can arise as a complication during the operation.In this paper, we aim to provide an overview of Takotsubo syndrome and to discuss how to manage Takotsubo during surgery and in anaesthesiologic special settings.

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Section: Treatment and Postoperative Carementioning

confidence: 99%

Perioperative management of Takotsubo cardiomyopathy: an overview

Pillitteri,

Brogi,

Piagnani

et al. 2024

J Anesth Analg Crit Care

View full text Add to dashboard Cite

show abstract

Takotsubo Syndrome and Gender Differences: Exploring Pathophysiological Mechanisms and Clinical Differences for a Personalized Approach in Patient Management

Giubilato,

Francese,

Manes

et al. 2024

JCM

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Takotsubo syndrome (TTS), also known as the broken-heart syndrome, is a reversible condition typically observed in female patients presenting for acute coronary syndromes (ACS). Despite its increasing incidence, TTS often remains undiagnosed due to its overlap with ACS. The pathophysiology of TTS is complex and involves factors such as coronary vasospasm, microcirculatory dysfunction, increased catecholamine levels, and overactivity of the sympathetic nervous system. Diagnosing TTS requires a comprehensive approach, starting with clinical suspicion and progressing to both non-invasive and invasive multimodal tests guided by a specific diagnostic algorithm. Management of TTS should be personalized, considering potential complications, the presence or absence of coronary artery disease (CAD), diagnostic test results, and the patient’s clinical course. The current data primarily derive from case series, retrospective analyses, prospective registries, and expert opinions. In recent years, there has been growing recognition of gender differences in the pathophysiology, presentation, and outcomes of TTS. This review provides an updated overview of gender disparities, highlighting the importance of tailored diagnostic and management strategies.

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Mechanical Circulatory Support Strategies in Takotsubo Syndrome with Cardiogenic Shock: A Systematic Review

Cited by 2 publications

References 75 publications

Perioperative management of Takotsubo cardiomyopathy: an overview

Perioperative management of Takotsubo cardiomyopathy: an overview

Takotsubo Syndrome and Gender Differences: Exploring Pathophysiological Mechanisms and Clinical Differences for a Personalized Approach in Patient Management

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