Takotsubo cardiomyopathy: Report of the first case series in Serbia and review of the literature

Abstract

Introduction. Takotsubo cardiomyopathy is a relatively novel cardiac syndrome that is characterized by transient left ventricular asynergy involving apical and mid-ventricular segments. Epidemiology and pathophisiology. It occurs predominantly in elderly women in the absence of obstructive coronary artery disease and is usually associated with severe emotional or physical stress. This syndrome is manifested with chest pain, electrocardiographic changes that mimic acute myocardial infarction, and minimal myocardial enzy?matic release. Several different mechanisms have been proposed: coronary artery spasm, dynamic left ventricular outflow/intracavitary obstruction, coronary microvascular dysfunction and direct catecholamine-mediated cardiomyocite injury. Therapy and prognosis. Complete recovery usually occurs after dramatic presentation, frequently complicated with acute heart failure. Therapy is empiric and directed towards supportive measures against cardiogenic shock, acute heart failure, dysrhythmias. In-hospital mortality rate is less than 1%, but long-term prognosis is still unknown. In addition to the review of the literature on takotsubo cardiomyopathy, we present the first series of patients with this syndrome detected in Clinical Hospital Center Zemun.