Takotsubo cardiomyopathy in elderly female trauma patients: a case series

Patel, Vishal; Levy, Shuli; Malik, Iqbal; Fertleman, Michael; Koizia, Louis

doi:10.1186/s13256-021-03056-1

Cited by 7 publications

(6 citation statements)

References 34 publications

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“…27 Noncardiac medical conditions, in particular, neurological, such as intracranial hemorrhage, pheochromocytoma, and epilepsy, or severe acute critical illnesses can induce takotsubo syndrome. [28][29][30] Cancer is increasingly recognized as a precipitant, and this may relate to the direct mental stress from receiving a diagnosis of malignancy or the combined mental and physical stress of cancer treatments. 31 Stresses from a range of physical illnesses or procedures are also recognized and include acute exacerbations of asthma or chronic obstructive pulmonary disease, endoscopic examinations, cardioversions, and many others.…”

Section: Clinical Featuresmentioning

confidence: 99%

Takotsubo Syndrome: Pathophysiology, Emerging Concepts, and Clinical Implications

et al. 2022

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Takotsubo syndrome is a condition characterized by acute transient left ventricular systolic dysfunction, which at presentation can be challenging to distinguish from acute myocardial infarction. Although previously thought to be a benign, self-limiting condition, recent studies have confirmed that patients with takotsubo syndrome have persistent subtle ongoing cardiac dysfunction, and many continue to have limiting symptoms despite restoration of left ventricular ejection fraction. Moreover, these patients have a substantial burden of morbidity and mortality, as well, with high rates of subsequent major adverse cardiovascular events that approach those of patients with acute coronary syndrome. The mechanisms behind this condition remain elusive. Despite substantial research, the medical community continues to have an incomplete understanding of its underlying pathogenesis and pathophysiology. Catecholamine-induced myocardial injury is the most established and well-known theory, but this does not explain all the clinical features and presentations of the condition, and numerous other pathways and abnormalities are emerging. Because of the poor understanding of its underlying pathophysiology, there is a lack of evidence-based interventions to treat the acute episode, to avoid recurrences, and to prevent major adverse cardiovascular events. This highlights the need for further research to gain a better understanding of the underlying pathophysiology to inform appropriate randomized controlled trials of interventions targeting the causative pathways. Only then can evidence-based management strategies be established to improve clinical outcomes of this potentially lethal condition.

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Section: Clinical Featuresmentioning

confidence: 99%

Takotsubo Syndrome: Pathophysiology, Emerging Concepts, and Clinical Implications

et al. 2022

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“…The differential diagnosis for post-traumatic chest pain is wide, so it is important that all possibilities are considered. Nevertheless, misdiagnosis of TTC may lead to postponement of necessary interventions, particularly in the case of trauma patients [ 3 ].…”

Section: Discussionmentioning

confidence: 99%

“…Takotsubo Cardiomyopathy (TTC), also known as stress-induced cardiomyopathy or Broken Heart Syndrome was first described in 1990. It is characterized by reversible left ventricular (LV) apical ballooning in the absence of angiographically significant coronary artery disease [ 1 , 3 ]. While the exact pathophysiology underlying stress cardiomyopathy is not known, there are well known characteristics documented throughout the literature.…”

Section: Introductionmentioning

confidence: 99%

Takotsubo cardiomyopathy following blunt trauma: Early recognition and diagnosis

Cimaroli

Maniar

Ciancarelli

et al. 2023

Trauma Case Reports

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“…The diagnosis of TTC is based upon the Mayo Clinic or International Takotsubo Diagnostic Criteria (Appendix) and requires careful differentiation from acute coronary syndrome, given their similar clinical electrocardiogram and enzymatic presentations, yet without obstructive coronary artery disease or plaque rupture [1,2]. Prompt diagnosis of TTC is important to minimize the risk for adverse events, as early diagnosis can inform clinical management and consequently optimize the timing of surgical interventions [6][7][8][9][10]. The spontaneous resolution of left ventricular wall motion abnormalities in TTC usually occurs in hours to weeks, and elective procedures can be delayed until the resolution of the cardiomyopathy [6].…”

Section: Introductionmentioning

confidence: 99%

“…In the trauma literature, TTC has been reported in 10% of patients with traumatic brain injury [15], 18.4% with extreme physical activity or trauma [16], and 15% with perioperative myocardial damage and hip fracture. However, this information on TTC is not related to the trauma population in general and predominantly represents a series of cases involving limited traumas [4,7,10,13,[17][18][19]. This study is the first report assessing the TTC information available from the National Trauma Data Bank (NTDB) to better characterize the disease among the broad spectrum of traumatic injuries.…”

Section: Introductionmentioning

confidence: 99%

Takotsubo Cardiomyopathy and Trauma: The Role of Injuries as Physical Stressors

Fernández¹,

Narveson²,

Walters³

et al. 2022

Cureus

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Introduction: Physical stressors are common predisposing factors for takotsubo cardiomyopathy (TTC). However, the role of traumatic injuries in TTC has not been well defined. This study describes the characteristics of TTC in the broad spectrum of traumatic injuries using the information available in the National Trauma Data Bank (NTDB).Materials and methods: This retrospective study analyzed trauma patients ≥ 18 years old in the NTDB, from 2007 to 2018, with a diagnosis of TTC.Results: A total of 95 TTC diagnoses were found. The median age was 68 years old (interquartile range: 55-80). Patients were predominantly female (67.4%), white (88.4%), and sustained blunt mechanisms of injury (90.5%). Penetrating trauma was most common in males (16%). Most diagnoses were related to extremity trauma (53.7%), followed by head injury (26.3%). The most common severity scores were Glasgow Coma Scale (GCS) > 13 or < 8, and Injury Severity Score (ISS) < 15 or > 25. Males more commonly presented with GCS < 8 (68%), ISS > 25 (33%), high intensive care unit (ICU) admission rate (77.4%), and mechanical ventilation (51.6%). The median duration of the mechanical ventilation was eight days for both sexes. The ICU length of stay (LOS) was six days with a hospital LOS of nine days and a trend toward a longer LOS in males. The in-hospital mortality rate was 11.7% for both sexes.Conclusions: TTC in traumatic injuries is common at both ends of the severity spectrum and has different sex distribution. TTC patients are predominantly females and have more commonly extremity trauma than head injury. Males are more severely injured and under mechanical ventilation.

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Takotsubo cardiomyopathy in elderly female trauma patients: a case series

Cited by 7 publications

References 34 publications

Takotsubo Syndrome: Pathophysiology, Emerging Concepts, and Clinical Implications

Takotsubo Syndrome: Pathophysiology, Emerging Concepts, and Clinical Implications

Takotsubo cardiomyopathy following blunt trauma: Early recognition and diagnosis

Takotsubo Cardiomyopathy and Trauma: The Role of Injuries as Physical Stressors

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