Pathology of Takotsubo (Ampulla) Cardiomyopathy

Kawai, Sachio

doi:10.5772/29050

Cited by 8 publications

(13 citation statements)

References 18 publications

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“…The pathophysiology of this syndrome appears to be related to an excess of plasma catecholamines, which are triggered by stressful conditions. Histological findings are consistent with catecholamine cardiotoxicity, due to ischaemia-reperfusion injury, both in human myocardial samples and in experimental models of SCMP 11 12 23–32. The crucial role of myocardial ischaemia in Takotsubo syndrome has been identified, with most cases occurring in patients with a risk factor for endothelial dysfunction.…”

Section: Introductionsupporting

confidence: 75%

Stress cardiomyopathy in stranded cetaceans: a histological, histochemical and immunohistochemical study

et al. 2019

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BackgroundFree-living cetaceans are exposed to a wide variety of stressful situations, including live stranding and interaction with human beings (capture myopathy), vessel strikes, and fishing activities (bycatch), which affect their wellbeing and potentially lead to stress cardiomyopathy (SCMP).MethodsHere, the authors aimed to characterise SCMP of stranded cetaceans as an injury resulting from extreme stress responses, based on pathological analyses (histological, histochemical and immunohistochemical). Specifically, the authors examined heart samples from 67 cetaceans found ashore (48 live strandings, seven dead from ship collision and 12 dead from bycatch) on the coast of Spain, more specifically in the Canary Islands from 2000 to 2016 and Andalusia from 2011 to 2014.ResultsThe microscopic findings were characterised by vascular changes, acute or subacute cardiac degenerative necrotic lesions, interstitial myoglobin globules, and infiltration of inflammatory cells. Immunohistochemically, cardiac troponin I, cardiac troponin C and myoglobin were depleted, along with fibrinogen being expressed in the degenerated/necrotic cardiomyocytes. A perivascular pattern was also identified and described in the damaged cardiomyocytes.ConclusionsThis study advances current knowledge about the pathologies of cetaceans and their implications on conserving this group of animals by reducing mortality and enhancing their treatment and subsequent rehabilitation to the marine environment.

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Section: Introductionsupporting

confidence: 75%

Stress cardiomyopathy in stranded cetaceans: a histological, histochemical and immunohistochemical study

et al. 2019

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“…Although this animal presented with clinical and pathological findings resembling rhabdomyolysis, which can lead to a secondary myoglobinuric nephrosis, lesions associated with acute kidney injury (i.e., intrinsic kidney disease/ damage or acute tubular necrosis) were not detected through the histopathological and immunohistochemical studies (1,9,10,12,(16)(17)(18)(19)(20)(21)(22)(23)(24)(25)(26)(27)64).…”

Section: Discussion Of the Immunohistochemical Resultsmentioning

confidence: 93%

“…These changes result in local-togeneralized vasospasms and vasodilation (catecholamine surge, neurogenic shock, and impeded venous flow return by body compression), which is analogous to the stress cardiomyopathy in humans and in direct traumatic injury to muscles, resulting in acute to subacute degeneration (rhabdomyolysis). Acute renal failure associated with myoglobinuric nephrosis secondary to muscle damage and areas of necrosis in viscera are also observed (1,9,10,12,(16)(17)(18)(19)(20)(21)(22)(23)(24)(25)(26)(27).…”

Section: Introductionmentioning

confidence: 99%

Skeletal and Cardiac Rhabdomyolysis in a Live-Stranded Neonatal Bryde's Whale With Fetal Distress

et al. 2019

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The main objective of wildlife forensic investigation is to recognize pathologic changes and cause of death. Even though it may not always be possible to determine the specific illness and/or etiology, the description and subsequent interpretation of the injuries provide an invaluable understanding of pathology in cetacean post-mortem investigations. Although pathological studies have been previously reported in various cetacean species, such descriptions of the infraorder Mysticeti remain rare. A live-stranded neonatal Bryde's whale (Balaenoptera edeni) which subsequently died soon after the stranding, was assessed by physical exam, blood examination, gross necropsy evaluation, histopathology, and immunohistochemistry. It presented with elevated serum levels of creatine kinase, cardiac troponin I, urea, and creatinine. Microscopically, we observed keratin spicules (squamous epithelial cells) and areas of atelectasis in the lungs. Acute degeneration in the myocytes and cardiomyocytes were comparable to the findings previously described in cases of capture myopathy in live-stranded cetaceans. Immunohistochemistry biomarkers such as myoglobin, fibrinogen, and troponin were analyzed. Skeletal and myocardial damage has been documented in several cetacean species. However, this is the first reported case of skeletal and cardiac rhabdomyolysis associated with live-stranding in a newborn Bryde's whale that suffered from fetal distress.

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“…A notable exception occurs when early myocardial infarction results in sudden cardiac death leaving only evidence of intracoronary thrombi [24]. Stress cardiac cardiomyopathy can be identified by histological and biochemical changes even in the absence of infarction [25]. Myocardial fibrosis, hypertrophy, and interstitial hypercellularity may be substrates for arrhythmias [26] and chronic tachycardia causes changes in ventricular wall thickness [27].…”

Section: Resultsmentioning

confidence: 99%

Comprehensive Histological and Immunochemical Forensic Studies in Deaths Occurring in Custody

Nugent

Orellana-Barrios²,

Buscemi

2017

International Scholarly Research Notices

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In-custody deaths have several causes, and these include homicide, suicide, natural death from chronic diseases, and unexplained death possibly related to acute stress, asphyxia, excited delirium, and drug intoxication. In some instances, these deaths are attributed to undefined accidents and natural causes even though there is no obvious natural cause apparent after investigation. Understanding these deaths requires a comprehensive investigation, including documentation of circumstances surrounding the death, review of past medical history, drug and toxicology screens, and a forensic autopsy. These autopsies may not always clearly explain the death and reveal only nonspecific terminal events, such as pulmonary edema or cerebral edema. There are useful histologic and biochemical signatures which identify asphyxia, stress cardiomyopathy, and excited delirium. Identifying these causes of death requires semiquantitative morphologic and biochemical studies. We have reviewed recent Bureau of Justice Statistics on in-custody death, case series, and morphological and biochemical studies relevant to asphyxia, stress cardiomyopathy, and excited delirium and have summarized this information. We suggest that regional centers should manage the investigation of these deaths to provide more comprehensive studies and to enhance the expertise of forensic pathologists who would routinely manage potentially complex and difficult cases.

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Pathology of Takotsubo (Ampulla) Cardiomyopathy

Cited by 8 publications

References 18 publications

Stress cardiomyopathy in stranded cetaceans: a histological, histochemical and immunohistochemical study

Stress cardiomyopathy in stranded cetaceans: a histological, histochemical and immunohistochemical study

Skeletal and Cardiac Rhabdomyolysis in a Live-Stranded Neonatal Bryde's Whale With Fetal Distress

Comprehensive Histological and Immunochemical Forensic Studies in Deaths Occurring in Custody

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