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A Comparative Retrospective Study of Patients with Takotsubo Syndrome and Acute Coronary Syndrome.
Isr Med Assoc J. 2021 Feb; 23(2):107-110.IM

Abstract

BACKGROUND

Takotsubo syndrome (TTS) is a non-ischemic cardiomyopathy characterized by an acute reversible left ventricular dysfunction with typical apical ballooning, usually with subsequent complete spontaneous recovery. TTS shares several features with acute coronary syndrome (ACS), including clinical presentation, ECG changes, and elevated troponin.

OBJECTIVES

To identify different features that may help differentiate between TTS and ACS with presentation based on presenting symptoms and physical examination.

METHODS

We compared 35 patients who TTS had been diagnosed with 60 age- and sex- matched patients with ACS (both ST and non-ST segment elevation myocardial infarction) who were hospitalized in Galilee Medical Center through 2011-2015.Basic characteristics and clinical features of the two groups were compared using appropriate statistical tests.

RESULTS

Of the patients with TTS, 21 (60%) reported an emotional trigger (60%) before admission, although they did not have increased prevalence of psychiatric disease compared to ACS patients (5.7% vs. 5%, P = 0.611). There was no difference in the type of chest pain or accompanied symptoms between the groups. Of notice, ECG changes in the TTS group were prominent in the anterior leads, and the patients presented with higher heart rate (86 ± 17 vs. 79 ± 15, P = 0.029) and lower systolic blood pressure (129 ± 26 vs. 142 ± 30, P = 0.034) on admission compared to the ACS group.

CONCLUSIONS

There was no reliable feature that could distinguish TTS from ACS based on clinical presentation. TTS should always be in the differential diagnosis in patients with acute chest pain, especially in elderly women.

Authors+Show Affiliations

Department of Cardiology, Galilee Medical Center, Nahariya, Israel. Faculty of Medicine in the Galilee, Bar-Ilan University, Safed, Israel.Faculty of Medicine in the Galilee, Bar-Ilan University, Safed, Israel.Department of Cardiology, Galilee Medical Center, Nahariya, Israel. Faculty of Medicine in the Galilee, Bar-Ilan University, Safed, Israel.

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

33595216

Citation

Moady, Gassan, et al. "A Comparative Retrospective Study of Patients With Takotsubo Syndrome and Acute Coronary Syndrome." The Israel Medical Association Journal : IMAJ, vol. 23, no. 2, 2021, pp. 107-110.
Moady G, Vons S, Atar S. A Comparative Retrospective Study of Patients with Takotsubo Syndrome and Acute Coronary Syndrome. Isr Med Assoc J. 2021;23(2):107-110.
Moady, G., Vons, S., & Atar, S. (2021). A Comparative Retrospective Study of Patients with Takotsubo Syndrome and Acute Coronary Syndrome. The Israel Medical Association Journal : IMAJ, 23(2), 107-110.
Moady G, Vons S, Atar S. A Comparative Retrospective Study of Patients With Takotsubo Syndrome and Acute Coronary Syndrome. Isr Med Assoc J. 2021;23(2):107-110. PubMed PMID: 33595216.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - A Comparative Retrospective Study of Patients with Takotsubo Syndrome and Acute Coronary Syndrome. AU - Moady,Gassan, AU - Vons,Shelly, AU - Atar,Shaul, PY - 2021/2/17/entrez PY - 2021/2/18/pubmed PY - 2021/2/23/medline SP - 107 EP - 110 JF - The Israel Medical Association journal : IMAJ JO - Isr Med Assoc J VL - 23 IS - 2 N2 - BACKGROUND: Takotsubo syndrome (TTS) is a non-ischemic cardiomyopathy characterized by an acute reversible left ventricular dysfunction with typical apical ballooning, usually with subsequent complete spontaneous recovery. TTS shares several features with acute coronary syndrome (ACS), including clinical presentation, ECG changes, and elevated troponin. OBJECTIVES: To identify different features that may help differentiate between TTS and ACS with presentation based on presenting symptoms and physical examination. METHODS: We compared 35 patients who TTS had been diagnosed with 60 age- and sex- matched patients with ACS (both ST and non-ST segment elevation myocardial infarction) who were hospitalized in Galilee Medical Center through 2011-2015.Basic characteristics and clinical features of the two groups were compared using appropriate statistical tests. RESULTS: Of the patients with TTS, 21 (60%) reported an emotional trigger (60%) before admission, although they did not have increased prevalence of psychiatric disease compared to ACS patients (5.7% vs. 5%, P = 0.611). There was no difference in the type of chest pain or accompanied symptoms between the groups. Of notice, ECG changes in the TTS group were prominent in the anterior leads, and the patients presented with higher heart rate (86 ± 17 vs. 79 ± 15, P = 0.029) and lower systolic blood pressure (129 ± 26 vs. 142 ± 30, P = 0.034) on admission compared to the ACS group. CONCLUSIONS: There was no reliable feature that could distinguish TTS from ACS based on clinical presentation. TTS should always be in the differential diagnosis in patients with acute chest pain, especially in elderly women. SN - 1565-1088 UR - https://www.unboundmedicine.com/medline/citation/33595216/A_Comparative_Retrospective_Study_of_Patients_with_Takotsubo_Syndrome_and_Acute_Coronary_Syndrome. L2 - http://www.ima.org.il/IMAJ/ViewArticle.aspx?year=2021&month=02&page=107 DB - PRIME DP - Unbound Medicine ER -