Takotsubo syndrome: between evidence, myths, and misunderstandings

Napp, L. Christian; Bauersachs, Johann

doi:10.1007/s00059-020-04906-2

Cited by 35 publications

(54 citation statements)

References 131 publications

(147 reference statements)

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“…Certain changes are observable also on the T and P waves [ 139 ]. We also have some weakly proven references about changes in the P wave in choleric patients, and the study of broken heart syndrome [ 140 ] is also interesting. In general, we do not consider ECG curve abnormalities to be significant for stress-meter development purposes.…”

Section: Physiological Variables In Stress Measurementmentioning

confidence: 99%

The Concept of Advanced Multi-Sensor Monitoring of Human Stress

Vavrinský

Stopjaková

Kopáni

et al. 2021

Sensors

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Many people live under stressful conditions which has an adverse effect on their health. Human stress, especially long-term one, can lead to a serious illness. Therefore, monitoring of human stress influence can be very useful. We can monitor stress in strictly controlled laboratory conditions, but it is time-consuming and does not capture reactions, on everyday stressors or in natural environment using wearable sensors, but with limited accuracy. Therefore, we began to analyze the current state of promising wearable stress-meters and the latest advances in the record of related physiological variables. Based on these results, we present the concept of an accurate, reliable and easier to use telemedicine device for long-term monitoring of people in a real life. In our concept, we ratify with two synchronized devices, one on the finger and the second on the chest. The results will be obtained from several physiological variables including electrodermal activity, heart rate and respiration, body temperature, blood pressure and others. All these variables will be measured using a coherent multi-sensors device. Our goal is to show possibilities and trends towards the production of new telemedicine equipment and thus, opening the door to a widespread application of human stress-meters.

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Section: Physiological Variables In Stress Measurementmentioning

confidence: 99%

The Concept of Advanced Multi-Sensor Monitoring of Human Stress

Vavrinský

Stopjaková

Kopáni

et al. 2021

Sensors

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“…However, in a clinical setting, it is not usual to anticipate a rare and complex pathology such as Takotsubo syndrome (TS) in young, healthy patients with no risk factors [ 2 – 5 ]. Essentially, TS is characterized by acute cardiac dysfunction with a typical regional wall motion abnormality (RWMA), but unlike most other cardiac pathologies, patients achieve full recovery within a short period [ 2 – 4 , 6 , 7 ]. The clinical presentation can be varied, ranging from non-specific symptoms to a life-threatening presentation [ 4 , 7 – 10 ].…”

Section: Introductionmentioning

confidence: 99%

“…Essentially, TS is characterized by acute cardiac dysfunction with a typical regional wall motion abnormality (RWMA), but unlike most other cardiac pathologies, patients achieve full recovery within a short period [ 2 – 4 , 6 , 7 ]. The clinical presentation can be varied, ranging from non-specific symptoms to a life-threatening presentation [ 4 , 7 – 10 ]. Chest pain and dyspnea on exertion are the most common symptoms of TS, seen in 67–81% of patients, with chest pain being the prime symptom [ 2 , 7 , 11 ].…”

Section: Introductionmentioning

confidence: 99%

“…Chest pain and dyspnea on exertion are the most common symptoms of TS, seen in 67–81% of patients, with chest pain being the prime symptom [ 2 , 7 , 11 ]. Almost 80–90% of patients with TS are elderly, postmenopausal women aged above 60 years [ 2 , 4 , 7 , 11 ]. Therefore, diagnosing TS is challenging in healthy young patients who present with mild symptoms [ 2 , 4 , 7 , 11 ].…”

Section: Introductionmentioning

confidence: 99%

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Takotsubo syndrome as an overlooked and elusive cause of a single episode of dyspnea in young women: a case report

Lee

Kang³

et al. 2021

BMC Cardiovasc Disord

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Background Dyspnea is a common symptom in patients presenting to the emergency department. It has a variety of causes that range from non-urgent to life-threatening. One episode of dyspnea in a healthy young person is easy to overlook. However, if the symptoms occur after physically or emotionally stressful events, careful evaluation needs to be undertaken because it may be associated with Takotsubo syndrome, which is rarely expected but can be fatal. Herein, we report the case of Takotsubo syndrome in a healthy young woman who arrived at the emergency department after experiencing a short single episode of dyspnea following a minor surgery. Case presentation A 23-year old woman with no underlying chronic disease underwent closed reduction surgery for a nasal bone fracture under general anesthesia (with sevoflurane as the anesthetic). Approximately 5 h later, she presented to the emergency department with dyspnea, which improved soon upon arrival at the emergency department. There were no other symptoms. The dyspnea occurred about 5 h after being discharged on observation, with an uneventful postoperative course. Her electrocardiogram and chest X-ray findings were unremarkable. On testing, troponin I and creatine kinase myocardial band levels were elevated at 6.122 ng/mL and 11.2 µg/L (reference ranges: 0.000–0.046 ng/mL and 0.0–5.0 µg/L), respectively. Bedside echocardiography revealed an ejection fraction of 25%, with mid-ventricular and apical akinesia and basal hyperkinesia. The pulmonary and coronary angiographic computed tomographic scans were unremarkable. Hence, apical Takotsubo syndrome was suspected. A follow-up echocardiogram taken 5 days after admission showed full recovery with a normalized ejection fraction (60%) and no regional wall motion abnormality. The patient was discharged on the sixth day with no other complications. Conclusion When atypical symptoms, such as transient dyspnea, manifest, it becomes necessary to suspect and diagnose Takotsubo syndrome to ensure timely and appropriate medical management, especially when a preceding stressful event, such as minor surgery has occurred. It might be helpful to perform bedside point-of-care echocardiography to check for regional wall motion abnormalities that are typically associated with Takotsubo syndrome.

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“…As above-mentioned, the syndrome usually worsens with physical and emotional stress secondary to non-heart disease and surgery. Given the abundance and recurring high level of emotional stress in current everyday life, the incidence of TTS is inadequately low [5]. Accordingly, it is appropriate to underline that only some individuals develop TTS, even if exposed to same stressors.…”

Section: Introductionmentioning

confidence: 99%

Genetic and Epigenetic Factors of Takotsubo Syndrome: a Systematic Review

Ferradini¹,

Vacca²,

Belmonte³

et al. 2021

Preprint

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Takotsubo syndrome (TTS), recognized as stress’s cardiomyopathy, or better as left ventricular apical balloon syndrome in the recent years, is a rare pathology, described for the first time by Japanese researchers in 1990. TTS is characterized by an interindividual heterogeneity in onset and progression, and by the strong predominance in postmenopausal women. The clear causes of these TTS features are uncertain, given the reduced understanding of this intriguing syndrome until now. However, the increasing frequency of TTS cases in the last years, and particularly correlated to SARS-CoV-2 pandemic, leads us to imperative necessity both of a complete knowledge of TTS pathophysiology for identifying biomarkers facilitating its management, and targets for specific and effective treatments. The suspect of a genetic basis in TTS pathogenesis has been evidenced. Accordingly, familial form of TTS has been described. But a systematic and comprehensive characterization of the genetic or epigenetic factors significantly associated with TTS is lacking. Thus, we, here, conducted a systematic review of literature before June 2021, to contribute to identify potential genetic and epigenetic factors associated with TTS. Interesting data were evidenced, but of reduced number and with diverse limitations. Consequently, we concluded further work is needed to address the gaps discussed, and probably a clear evidence may arrive using multi-omics investigations.

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Takotsubo syndrome: between evidence, myths, and misunderstandings

Cited by 35 publications

References 131 publications

The Concept of Advanced Multi-Sensor Monitoring of Human Stress

The Concept of Advanced Multi-Sensor Monitoring of Human Stress

Takotsubo syndrome as an overlooked and elusive cause of a single episode of dyspnea in young women: a case report

Genetic and Epigenetic Factors of Takotsubo Syndrome: a Systematic Review

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