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Takotsubo syndrome (TTS) is characterized by apical or left ventricular (LV) ballooning and impaired wall motion as its primary features. Although women over 55 years make up the majority of TTS patients, male patients have a greater incidence of in-hospital mortality. TTS also impacts pregnant women and children, with conflicting information regarding racial differences. TTS has an in-hospital mortality rate comparable to that of acute ST-segment elevation myocardial infarction, and higher than that in patients with myocarditis. More than 10% of patients may experience a subsequent acute episode within 5 years after the initial event. TTS exhibits symptoms such as chest pain, electrocardiograph (ECG) abnormalities, elevated B-type natriuretic peptide (BNP), and N-terminal prohormone of brain natriuretic peptide (NT-pro-BNP) levels, and changes in several imaging approaches, which may aid in early diagnosis. Fluid resuscitation, β-blockers, angiotensin-converting enzyme (ACE) inhibitors, angiotensin receptor blockers (ARBs), anti-anxiety or depression drugs, and cardiac rehabilitation may be employed to treat TTS, reduce recurrence rates, and improve functional exercise capacity and exercise time. After searching PubMed, Research Gate, Science Direct, and Web of Science, we summarized recent researches on epidemiology, diagnosis, treatments, and prognosis. These findings provide a theoretical basis for future clinical practice and will aid doctors and researchers investigating the unknown aspects of TTS.
Takotsubo syndrome (TTS) is characterized by apical or left ventricular (LV) ballooning and impaired wall motion as its primary features. Although women over 55 years make up the majority of TTS patients, male patients have a greater incidence of in-hospital mortality. TTS also impacts pregnant women and children, with conflicting information regarding racial differences. TTS has an in-hospital mortality rate comparable to that of acute ST-segment elevation myocardial infarction, and higher than that in patients with myocarditis. More than 10% of patients may experience a subsequent acute episode within 5 years after the initial event. TTS exhibits symptoms such as chest pain, electrocardiograph (ECG) abnormalities, elevated B-type natriuretic peptide (BNP), and N-terminal prohormone of brain natriuretic peptide (NT-pro-BNP) levels, and changes in several imaging approaches, which may aid in early diagnosis. Fluid resuscitation, β-blockers, angiotensin-converting enzyme (ACE) inhibitors, angiotensin receptor blockers (ARBs), anti-anxiety or depression drugs, and cardiac rehabilitation may be employed to treat TTS, reduce recurrence rates, and improve functional exercise capacity and exercise time. After searching PubMed, Research Gate, Science Direct, and Web of Science, we summarized recent researches on epidemiology, diagnosis, treatments, and prognosis. These findings provide a theoretical basis for future clinical practice and will aid doctors and researchers investigating the unknown aspects of TTS.
Background: Previous publications in 2011, 2016, and 2022 have presented lists of drugs associated with takotsubo cardiomyopathy (TCM). This review aims to provide updated drug lists that have been reported as potential causes of TCM. Methods: Following the same methodology employed in previous reviews, a detailed investigation was carried out in the PubMed/Medline database from June 2022 to July 2023 to identify drug-induced TCM (DITC) case reports. Various search terms related to the drug-induced transient left ventricular ballooning syndrome, ampulla cardiomyopathy, apical ballooning syndrome, drug-induced broken heart syndrome, drug triggered takotsubo cardiomyopathy, takotsubo cardiomyopathy, and iatrogenic takotsubo cardiomyopathy were utilized. Filters for fulltext availability, case reports, human studies, and English language were applied. Articles reporting drugs associated with TCM development were included in the analysis. Results: Foremost 192 case reports were initially identified, with 75 drugs meeting the inclusion criteria after a thorough review. The latest revision identified seven drugs that might lead to TCM, with four drugs (57.14%) already reported in previous reviews and three drugs (42.86%) newly identified. Consequently, the updated drug list potentially triggering TCM in 2023 comprises a sum of 75 drugs. Conclusion: The recent 75 drugs provided additional evidence linking to TCM development. The updated list predominantly includes drugs that induce sympathetic overstimulation, although some drugs on the list have unclear associations with sympathetic nervous system activation.
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