Shock begets shock: A case of direct current cardioversion–induced takotsubo cardiomyopathy

Zaghlol, Raja; Hritani, Rama; O’Donoghue, Susan

doi:10.1016/j.hrcr.2019.02.013

Cited by 8 publications

(5 citation statements)

References 15 publications

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“…Absent abnormal Q-waves along with lack of reciprocal changes, without ST-segment elevation in lead V1, and ST-segment elevation in aVR showed more than 91% sensitivity and 96% specificity for the diagnosis of TCM. Other Imaging Techniques: Chest radiographs may show pulmonary edema [12][13] , but usually normal in majority of patients. Cardiac magnetic resonance imaging (CMR) may be reasonable for accurate evaluation of regional wall motion abnormalities seen in TCM, estimating ventricular function, and detecting reversible injury to the myocardium.…”

Section: Resultsmentioning

confidence: 99%

The Diagnostic Accuracy of Electrocardiogram in Differentiating Takotsubo Cardiomyopathy in Patients Presenting as Anterior Wall St-Segment Elevation Myocardial Infarction and Taking Coronary Angiography as Gold Standard

Muneeb,

Niazi,

Chatha

et al. 2023

PJMHS

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Myocardial infarction: Myocardial infarction is the irreparable damage to heart muscles resulting in necrosis & is the leading cause of death; resulting in 500,000-700,000 important deaths related to the coronary artery occur each year. Cardiovascular disease is the most common reason resulting in premature mortality as well as morbidity among various ethnic group of white, black and Hispanic populations. Takotsubo Cardiomyopathy: TCM is a condition that affects the heart reversible syndrome, characteristic of decrease(hypokinesia)/ near absent movement (akinesia) of distal half of interventricular septum & cardiac apex showed as apical ballooning on echocardiogram with absence of an obstructive defect in epicardial coronary arteries following an emotional disturbance. Objective: To determine the diagnostic accuracy of electrocardiographic findings (elevation < 1mm Takotsubo cardiomyopathy can be identified in lead V1 in patients who have anterior wall ST-segment elevation myocardial infarction by taking coronary angiography as gold standard. Design: Cross-sectional survey Subjects & Methods: Using 250 incidences in the sample, and a 95% confidence level, a 13% error margin, and the anticipated percentage of Takotsubo cardiomyopathy i.e, 18% by using 74.2% sensitivity and 80.6% specificity of electrocardiographic findings i.e, ST-elevation of > 1mm in V1 in the detection of Takotsubo cardiomyopathy when myocardial infarction with ST-elevation in the anterior wall is the presenting symptom and coronary angiography as gold standard2. Results: The patients were 49 + 13 years old on average. Sensitivity & specificity of ECG criteria were 40.78% & 78.65%. The positive & negative predictive values were 43.28% & 76.5% respectively. Practical Implication: Our study showed negative association of ST-elevation of >1mm in ECG lead V1 to differentiate TC from anterior wall myocardial infarction. Further studies should be done to probe into the diagnostic accuracy of ECG in differentiating TC from acute anterior wall myocardial infarction. Conclusion: Electrocardiography is not diagnostic for distinguishing acute anterior wall pain from Takotsubo cardiomyopathy myocardial infarction so additional investigations need to be performed to diagnose the Takotsubo Cardiomyopathy. Keywords: Myocardial infarction, Takotsubo cardiomyopathy, Electrocardiogram, diagnostic accuracy Coronary angiography.

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Section: Resultsmentioning

confidence: 99%

The Diagnostic Accuracy of Electrocardiogram in Differentiating Takotsubo Cardiomyopathy in Patients Presenting as Anterior Wall St-Segment Elevation Myocardial Infarction and Taking Coronary Angiography as Gold Standard

Muneeb,

Niazi,

Chatha

et al. 2023

PJMHS

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“…After removal of duplicates, a total of 11 articles yielded 11 cases which were included in the systematic review. The included studies were all case reports [12][13][14][15][16][17][18][19][20][21][22].…”

Section: Study Selection and Characteristicsmentioning

confidence: 99%

Takotsubo syndrome associated with cardioversion: a systematic review

et al. 2022

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Background Direct current cardioversion is a well-established and safe procedure to restore normal sinus rhythm for atrial and ventricular arrhythmias. Takotsubo syndrome has been rarely described with cardioversion. We reviewed the literature for descriptions of Takotsubo syndrome associated with the stress of cardioversion, to better understand its risks. Methods We queried MEDLINE, EMBASE, Google Scholar and Cochrane for cases of Takotsubo syndrome secondary to synchronized cardioversion as defined by Mayo Clinic Diagnostic Criteria. Results We identified 11 cases of cardioversion-associated Takotsubo syndrome. Average age was 76 years (range: 61–87 years) and most (10 out of 11, 91%) were female. Diagnosis was made soon after cardioversion (median: 10 h, range: 0–48 h). Only 2 of 11 had ST elevations noted, while apical ballooning was noted in all cases. Pulmonary edema developed in 6 and cardiogenic shock developed in 5 patients. The median recovery time was 7 days (range: 3–11). Conclusions Cardioversion-associated TS has an overall favorable outcome with complete recovery in most cases. A higher risk of this complication may exist for elderly females undergoing synchronized cardioversion.

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“…Although transient myocardial dysfunction is considered to be essential for the diagnosis of TTS there have been recent reports showing that full myocardial recovery can take more than 4 months after the acute event [2] . There have already been a number of TTS cases following electrical cardioversion that have been described in the literature [3][4][5][6][7] and a first episode of TTS is known to predispose for recurrences of the same condition [8] . This is however the first case of recurrent TTS following cardioversion that has to our knowledge been described in the literature.…”

Section: Case Presentationmentioning

confidence: 99%

Recurrent Post-Cardioversion Takotsubo Syndrome

Mangion¹,

Horlait²

2020

IJCR

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Takotsubo syndrome (TTS) is characterised by transient regional wall motion abnormalities of the left or right ventricles often associated with new ECG changes (including ST-segment elevations, ST-segment depressions, T-wave inversions and QTc prolongation) in the absence of a culprit atherosclerotic artery which could explain the ventricular dysfunction. In this article we present an unusual case of recurrent TTS following electrical cardioversion in a 61 year old female patient who was admitted to our unit.

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Shock begets shock: A case of direct current cardioversion–induced takotsubo cardiomyopathy

Cited by 8 publications

References 15 publications

The Diagnostic Accuracy of Electrocardiogram in Differentiating Takotsubo Cardiomyopathy in Patients Presenting as Anterior Wall St-Segment Elevation Myocardial Infarction and Taking Coronary Angiography as Gold Standard

The Diagnostic Accuracy of Electrocardiogram in Differentiating Takotsubo Cardiomyopathy in Patients Presenting as Anterior Wall St-Segment Elevation Myocardial Infarction and Taking Coronary Angiography as Gold Standard

Takotsubo syndrome associated with cardioversion: a systematic review

Recurrent Post-Cardioversion Takotsubo Syndrome

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