Usefulness of ECG to differentiate Takotsubo cardiomyopathy from acute coronary syndrome

Looi, Jen-Li; Wong, Chi-Wing; Lee, Mildred; Khan, Ali; Webster, Mark; Kerr, Andrew

doi:10.1016/j.ijcard.2015.07.046

Cited by 39 publications

(42 citation statements)

References 27 publications

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“…We noted a typical T-wave inversion on day 1, reaching its maximum with an amplitude of ≥ 3 mm and including ≥ 6 leads at day 2, later followed by a reversion of negative T wave starting on day 3, consistent with reports from Mitsuma et al [7] and Looi et al [9]. No giant negative T-wave was observed subsequently.…”

supporting

confidence: 91%

A broken heart in a broken car

Schlossbauer

Ghadri²,

Cammann³

et al. 2016

Cardiol J.

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supporting

confidence: 91%

A broken heart in a broken car

Schlossbauer

Ghadri²,

Cammann³

et al. 2016

Cardiol J.

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“…Of note, two of these studies only compared TT with STEMI patients in whom management would not be altered on the basis of biomarkers which are often available only after coronary angiography. Looi et al [20] showed the utility of analysing two ECG markers, namely the number of leads with T-wave inversion and peak T-wave inversion N3 mm, on the second day after admission. The product of peak troponin I to ejection fraction has also proved to be a potent discriminator (accuracy 91%) with STEMI patients [21].…”

Section: Discussionmentioning

confidence: 99%

Ratio of high-sensitivity troponin to creatine kinase-MB in takotsubo syndrome

Pirlet

Piérard

Legrand

et al. 2017

International Journal of Cardiology

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Background: Takotsubo syndrome (TT) and myocardial infarction (MI) share numerous similarities in clinical presentation, ECG modifications and biomarker elevation. We sought to determine whether the ratio of highsensitivity cardiac troponin T (hs-TnT) to the myocardial fraction of creatine kinase (CKMB) could be a potent discriminator between TT and MI patients. Methods: We separately present analysis of data from retrospective files and prospectively recruited patients presenting with TT (35 retrospective and 42 prospective), NSTEMI (48 retrospective and 75 prospective) and STEMI (20 retrospective and 39 prospective). We compared ratios of hs-TnT to CKMB on admission to the hospital between TT, NSTEMI and STEMI patients. Receiver operating characteristic (ROC) curves were analysed to determine optimal cut-off values. Conclusion: hs-TnT/CKMB ratio is a novel, readily available parameter that could be used alongside clinical risk scores, other biomarkers and ECG findings to discriminate between TT and MI.

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“…[36][37][38] Our group has recently published the largest cohort (n=100) published to date in Australasia and one of the largest cohorts internationally, evaluating ECG differences between TC and patients with myocardial infarction. 34 Compared with STEMI patients TC patients with ST-segment elevation on admission ECG had less prominent ST-segment elevation, less reciprocal ST-segment depression and no abnormal Q-waves. By Day 2 all STEMI patients had pathological Q-waves but none of the TC patients.…”

Section: Electrocardiogrammentioning

confidence: 94%

“…4 to 50% of TC patients in other series. 7,34,35 Several ECG features of TC have been reported which may help to differentiate TC from an ACS. These include absence of reciprocal changes, absence of abnormal Q-waves, absence of ST-segment elevation in lead V1, progressive QTc interval prolongation and widespread T-wave inversion (TWI).…”

Section: Electrocardiogrammentioning

confidence: 99%

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Clinical Characteristics and Outcomes of Takotsubo Cardiomyopathy

Looi¹,

Kerr²

2016

ICFJ

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Takotsubo cardiomyopathy (TC) is a transient, reversible form of cardiomyopathy which predominantly affects post-menopausal women and is an important differential diagnosis of acute coronary syndrome. It is characterised by normal (or near-normal) coronary arteries, regional wall motion abnormalities that extend beyond a single coronary vascular bed, and often proceeded by a stressful event. The pathophysiologic mechanism is complex and remains to be elucidated. There is increasing awareness among physicians about TC and hence, more cases are being reported. The diagnosis of TC has important clinical implications in the management at presentation and afterward. In this review, we discuss the demographics, clinical features, prognosis and management of this cardiomyopathy.

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Usefulness of ECG to differentiate Takotsubo cardiomyopathy from acute coronary syndrome

Cited by 39 publications

References 27 publications

A broken heart in a broken car

A broken heart in a broken car

Ratio of high-sensitivity troponin to creatine kinase-MB in takotsubo syndrome

Clinical Characteristics and Outcomes of Takotsubo Cardiomyopathy

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