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Background: Acute cardiac complications post-chemotherapy is rare. Stress cardiomyopathy, one of these complications, should be considered in differential diagnoses as its symptoms closely resemble those of acute myocardial infarction and can lead to mortality. Objective: The objective of this paper is to describe Takotsubo syndrome (TTS) as an acute complication following combined chemotherapy in a patient with significant thromboembolic burden and metastatic cervical cancer. Case: A 61-year-old female patient with a diagnosis of metastatic cervical cancer experienced acute chest pain. Elevated troponin levels and abnormalities in the electrocardiogram initially suggested an acute myocardial infarction, occurring after a chemotherapy session involving Carboplatin and Paclitaxel infusion. Although initial treatment targeted myocardial infarction, further diagnostic evaluations including coronary angiography and cardiac magnetic resonance imaging revealed no coronary artery disease but identified features consistent with stress cardiomyopathy, indicative of Takotsubo syndrome (TTS). This diagnosis led to an improvement in symptoms and a resolution of the acute changes observed. Conclusion: Stress cardiomyopathy, particularly TTS, is being increasingly recognized as an acute complication associated with combined chemotherapy regimens. The potential cardiotoxic effects of these chemotherapy agents demand careful monitoring and evaluation in patients undergoing oncological treatment, underscoring the importance of integrating cardioprotective strategies into the management of these patients.
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Background: Takotsubo cardiomyopathy (TM) is a form of non-ischemic cardiomyopathy. It is characterized by transient regional systolic dysfunction of the left ventricle that mimics acute myocardial infarction. The main objective of this article is to report the case of a patient with TM associated with abnormal birth of the left coronary trunk. Clinical case: A 76-year-old woman with typical angina at rest, with an electrocardiogram that showed dynamic changes in the T wave and elevation of biomarkers. Coronary angiography showed epicardial coronary arteries without significant lesions and abnormal birth of the left coronary trunk from the proximal segment of the right coronary artery. The patient progressed favorably, and the transthoracic echocardiogram showed no mobility disorders 3 months after the event. Conclusions: TM and abnormal birth of the coronary arteries are rare diseases whose simultaneous presentation is extraordinary. The diagnosis of both clinical entities is made by coronary angiography and echocardiogram, and their treatment is similar to that of patients with acute coronary syndrome. Abnormal birth of the left coronary trunk with retroaortic switch reaching the contralateral site has a good clinical prognosis and echocardiographic follow-up should be performed 4 weeks after the onset of the condition.
Introducción: la miocardiopatía de Takotsubo (MT) es una forma de miocardiopatía no isquémica. Se caracteriza por la disfunción sistólica regional transitoria del ventrículo izquierdo que imita al infarto agudo de miocardio. El objetivo principal de este artículo es reportar el caso de una paciente con MT asociada al nacimiento anómalo del tronco coronario izquierdo. Caso clínico: paciente mujer de 76 años que presentó angina típica en reposo, con un electrocardiograma que evidenció cambios dinámicos en la onda T y elevación de biomarcadores. La coronariografía evidenció a las arterias coronarias epicárdicas sin lesiones significativas y el nacimiento anómalo del tronco coronario izquierdo proveniente del segmento proximal de la arteria coronaria derecha. La paciente evolucionó de manera favorable y el ecocardiograma transtorácico no mostró trastornos en la movilidad a los tres meses del evento. Conclusiones: la MT y el nacimiento anómalo de las arterias coronarias son enfermedades raras cuya presentación simultánea es extraordinaria. El diagnóstico de ambas entidades clínicas se realiza mediante la coronariografía y el ecocardiograma, y su tratamiento es similar al de los pacientes con síndrome coronario agudo. El nacimiento anómalo del tronco coronario izquierdo con cruce retroaórtico que alcanza el sitio contralateral tiene un buen pronóstico y se debe realizar seguimiento clínico y ecocardiográfico a las cuatro semanas del inicio del padecimiento.
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Infarto do Miocárdio , Cardiomiopatia de Takotsubo , Feminino , Humanos , Idoso , Cardiomiopatia de Takotsubo/complicações , Cardiomiopatia de Takotsubo/diagnóstico , Vasos Coronários , Ecocardiografia , EletrocardiografiaRESUMO
We present the case of a 64-year-old female with stage IV gastric adenocarcinoma, pulmonary, and abdominal wall metastases, and no history of cardiovascular disease. In palliative care, she received systemic cytotoxic treatment with fluorouracil, leucovorin, oxaliplatin, and docetaxel protocol, which was well tolerated over five cycles. During cycle 6, she presented with cardiovascular symptoms with hemodynamic consequences while receiving oxaliplatin injection without docetaxel or 5-fluorouracil. She was transferred to the emergency department and then to the intensive care unit. She developed no complications during the hospital stay and was discharged after 10 days with preserved systolic function and no structural changes at the myocardial level. The electrocardiogram, echocardiogram, cardiac catheterization, and magnetic resonance imaging findings indicated an oxaliplatin-associated Takotsubo syndrome. The immunochemistry analysis showed PD-L1 expression level TPS: 40% and the foundation one genomic profiling revealed high mutation load, microsatellite instability, and HER2 not found. The patient is currently asymptomatic and on pembrolizumab monotherapy with good tolerance and partial treatment response.
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El síndrome de Takotsubo es una enfermedad cardíaca aguda que se presenta con un cuadro clínico similar al de un síndrome coronario agudo y se caracteriza por alteraciones segmentarias de la contracción ventricular transitorias, con un árbol coronario normal o con lesiones coronarias no significativas que las expliquen. Se observa, generalmente, en mujeres posmenopáusicas; el cual se desencadena principalmente por un estrés emocional o físico severo y su diagnóstico es un desafío clínico. Este artículo entrega una revisión de los factores desencadenantes y de riesgo y las principales hipótesis causales de esta enfermedad. Proporciona, además, una revisión actualizada de las pruebas diagnósticas que deben ser realizadas, el algoritmo para su diagnóstico, las complicaciones y el manejo terapéutico actual.
Takotsubo syndrome is an acute cardiomyopathy with a clinical presentation resembling an acute coronary syndrome. It is characterized by transient segmental ventricular dysfunction with a normal underlying coronary tree or coronary lesions that cannot explain the ventricular dysfunction. It is usually seen in postmenopausal women, triggered by severe emotional or physical stress, and is clinically challenging to diagnose. This article provides an exhaustive review of the risk factors, triggers, and main hypotheses to explain this disease. In addition, it provides an updated review of the diagnostic tests that must be performed, the diagnostic algorithms, their complications, and current therapeutic management.
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Humanos , Feminino , Cardiomiopatia de Takotsubo/diagnóstico , Cardiomiopatia de Takotsubo/fisiopatologia , Fatores de RiscoRESUMO
El síndrome de tako-tsubo es una miocardiopatía aguda por estrés, caracterizada por una anormalidad regional del movimiento de la pared del ventrículo izquierdo, con un patrón circunferencial peculiar que resulta en un abultamiento notorio del ventrículo izquierdo durante la sístole. En Cuba, el síndrome de tako-tsubo ha sido publicado en pacientes adultos, pero se considera una entidad rara en niños, razón por la cual se decidió hacer este reporte. Se presenta el caso de una adolescente de 16 años, con antecedentes de haber dado a luz hacía 44 días al momento del ingreso, que fue recibida en el Servicio de Emergencias en estado grave, con disnea, dolor precordial y manifestaciones de choque, por lo que fue derivada inmediatamente a la Unidad de Cuidados Intensivos Pediátricos. Los antecedentes de haber tenido un factor desencadenante de estrés como el parto por cesárea, el electrocardiograma con signos de isquemia miocárdica y el ecocardiograma típico, con discinesia de segmentos apicales del ventrículo izquierdo, permitieron hacer el diagnóstico de síndrome de tako-tsubo y dirigir el tratamiento en ese sentido. Este síndrome es infrecuente en la edad pediátrica, por tanto, puede presentarse como una forma grave y no ser reconocido, trayendo implicaciones pronósticas.
Takotsubo syndrome is an acute stress cardiomyopathy, characterized by a regional abnormality of left ventricular wall motion, with a peculiar circumferential pattern that results in marked left ventricular bulging during systole. In Cuba, takotsubo syndrome has been published in adult patients, but it is considered a rare entity in children, so it was decided to make this report. The case of a 16-years-old adolescent, with a history of having given birth 44 days before at the time of admission, who was received at the Emergency Department in serious condition, with dyspnea, precordial pain, and manifestations of shock, for what she was immediately referred to the Pediatric Intensive Care Unit it is presented. The history of having had a stress trigger such as delivery by cesarean section, the electrocardiogram with signs of myocardial ischemia, and the typical echocardiogram, with dyskinesia of the apical segments of the left ventricle, allowed the diagnosis of takotsubo syndrome and direct treatment in that sense. This syndrome is rare in the pediatric age, therefore, it can present as a severe form and not be recognized, bringing prognostic implications.
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BACKGROUND: A list of drugs that can induce takotsubo cardiomyopathy (TCM) was published in 2011 and 2016. The aim of the present review was to update this list. METHODS: Similar to the 2011 and 2016 reviews, from April 2015 to May 2022 case reports of druginduced TCM were identified by a comprehensive search in Medline/PubMed database. The search terms were: takotsubo cardiomyopathy, tako-tsubo cardiomyopathy, stress cardiomyopathy, transientleft- ventricular ballooning syndrome, apical ballooning syndrome, ampulla cardiomyopathy OR broken heart syndrome; together with "iatrogenic", "induced by" OR "drug-induced". Registers published in English or Spanish, in humans, and with full texts were retrieved. Articles that recognized any drug associated with the development of TCM were selected. RESULTS: Overall, 184 manuscripts were identified by the search. A total of 39 articles were included after an exhaustive revision. Eighteen drugs as possible triggers of TCM were identified in the current update. Of them, 3 (16.7%) have been previously identified, and 15 (83.3%) are different from the previous reports. Thus, the list of drugs as possible triggers of TCM updated in 2022 includes 72 drugs. CONCLUSION: There are new case reports that link drugs with the development of TCM. The current list is principally made up of drugs that generate sympathetic overstimulation. However, some of the listed drugs do not have a clear link with sympathetic activation.
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Cardiomiopatia de Takotsubo , Humanos , Cardiomiopatia de Takotsubo/induzido quimicamente , Cardiomiopatia de Takotsubo/diagnóstico , Cardiomiopatia de Takotsubo/complicações , Ventrículos do CoraçãoRESUMO
Resumen: Se presenta un caso de una mujer de 28 años, primera gesta, embarazo normoevolutivo, quien acudió a atención de parto, se realizó cesárea por falta de progresión. Durante el perioperatorio desarrolló atonía uterina y sangrado (2,000 mL), por lo que se le realizó histerectomía subtotal abdominal, embolización selectiva de vasos pélvicos, transfusión masiva y empaquetamiento pélvico. Evolucionó con vasoplejía y perfil hemodinámico compatible con choque cardiogénico, ecocardiograma transtorácico con disfunción sistólica severa, fracción de eyección de ventrículo izquierdo (FEVI) 18%, contractilidad normal en los tercios basales de la pared lateral. El resto de los segmentos con hipocinesia severa, NT-pro BNP 9,226 pg/mL, troponina de alta sensibilidad 490 pg/mL, electrocardiograma con taquicardia sinusal sin datos de lesión. Se estableció el diagnóstico de Takotsubo (miocardiopatía por estrés). Se colocó membrana de oxigenación extracorpórea (ECMO) V-A y balón de contrapulsación intraaórtica. Desarrolló lesión renal aguda y sobrecarga hídrica, por lo que se inició terapia de sustitución renal. La terapia ECMO se mantuvo durante nueve días, y se egresó a domicilio a los 18 días. El ECMO es una estrategia terapéutica para el soporte hemodinámico del choque cardiogénico incluyendo la cardiomiopatía por estrés; este caso ilustra su utilidad en el puerperio.
Abstract: We present a case of a 28-year-old woman currently in her first pregnancy, normal evolution, who attended delivery care, a cesarean section was performed due to lack of progression. During the perioperative period, she developed uterine atony and bleeding of 2,000 mL, for which she underwent a subtotal abdominal hysterectomy, selective embolization of the pelvic vessels, massive transfusion, and pelvic packing. She evolved with vasoplegia and hemodynamic profile compatible with cardiogenic shock, transthoracic echocardiogram exposes severe systolic dysfunction, LVEF 18%, normal contractility in the basal thirds of the lateral wall, the rest of the segments with severe hypokinesia, NT-pro BNP 9,226 pg/mL, high-sensitivity troponin 490 pg/mL, electrocardiogram whit sinus tachycardia with no evidence of injury, the diagnosis of Takotsubo (stress cardiomyopathy) was established. Extracorporeal membrane oxygenation (ECMO) V-A and intra-aortic balloon counterpulsation were placed. Acute kidney injury developed, and fluid overload, for which renal replacement therapy was started. ECMO therapy was maintained for nine days, and she was discharged home after 18 days. ECMO is an innovative therapeutic strategy for hemodynamic support of cardiogenic shock, including stress cardiomyopathy, and this case illustrates its potential utility in the postpartum period.
Resumo: Apresenta-se o caso de uma mulher de 28 anos, primigesta, gravidez evolução normal, que assistiu ao parto, tendo sido submetida a cesariana por falta de evolução. No período perioperatório, apresentou atonia uterina e sangramento (2,000 mL), sendo submetida a histerectomia abdominal subtotal, embolização seletiva de vasos pélvicos, transfusão maciça e tamponamento pélvico. Evoluiu com vasoplegia e quadro hemodinâmico compatível com choque cardiogênico, ecocardiograma transtorácico com disfunção sistólica grave, FEVE 18%, contratilidade normal nos terços basais da parede lateral, restante dos segmentos com hipocinesia grave, NT-pro BNP 9,226 pg/mL, troponina de alta sensibilidade 490 pg/mL, eletrocardiograma com taquicardia sinusal sem evidência de lesão, foi estabelecido o diagnóstico de Takotsubo (cardiomiopatia de estresse). Colocou-se uma oxigenação por membrana extracorpórea (ECMO) V-A e um balão de contrapulsação intra-aórtico. Evoluiu com lesão renal aguda e sobrecarga hídrica, sendo iniciada terapia renal substitutiva. A terapia com ECMO foi mantida por 9 dias e ele recebeu alta após 18 dias. A ECMO é uma estratégia terapêutica para suporte hemodinâmico do choque cardiogênico, incluindo a cardiomiopatia de estresse, e este caso ilustra sua utilidade no puerpério.
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Abstract This study presents a 47-year-old female patient, with a history of diabetes, who contracted SARS-CoV-2 and exhibited cardiovascular complications.
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Introduction: Takotsubo syndrome is a cardiomyopathy that can lead to severe myocardial involvement. It is characterized by the presence of signs and symptoms suggestive of ventricular dysfunction associated with an adrenergic discharge during a stressful event. This case report presents a literature review, as well as a comparison with other similar cases. Case presentation. A 56-year-old female with a previous episode of Takotsubo was admitted to the emergency department due to symptoms of acute coronary syndrome and a history of Takotsubo syndrome. Her electrocardiogram showed T-wave inversion in leads V1-V4 and a raise in troponins. Percutaneous coronary angiography revealed no coronary lesions, and an echocardiogram revealed segmental alterations compatible with Takotsubo syndrome, requiring medical therapy with beta-blockers and angiotensin-converting enzyme (ACE) inhibitors, with subsequent improvement in ventricular function. Conclusions. Recurrence in Takotsubo cardiomyopathy is a rare complication that should be suspected. The risk factors associated with recurrence are not known. Although therapy with ACE inhibitors and beta-blockers seems to have an impact on the recovery of ventricular function in patients with this condition, further studies are necessary to establish the best pharmacological treatment.
Introducción. La miocardiopatía de Takotsubo (MT) es una afección cardiaca que puede generar compromiso miocárdico severo y se caracteriza por la presencia de signos y síntomas sugestivos de disfunción ventricular que se asocian a una descarga adrenérgica durante un evento estresor. En este reporte de caso se realizó una revisión de la literatura y se hizo una comparación con otros casos similares al presentado. Presentación del caso. Mujer de 56 años, quien asistió al servicio de urgencias por síntomas sugestivos de un síndrome coronario agudo. A la paciente, que tenía antecedente de MT, se le realizó un electrocardiograma que mostró inversión de la onda T en las derivaciones V1-V4 y elevación de troponinas, una angiografía coronaria que evidenció arterias epicárdicas sin lesiones y un ecocardiograma que reveló alteraciones segmentarias compatibles con MT, por lo que se estableció manejo con betabloqueadores e inhibidores de la enzima convertidora de angiotensina (IECA), con lo cual se logró mejoría de la función ventricular. Conclusiones. La MT es una afección poco frecuente de la cual no se conocen los factores de riesgo asociados a su recurrencia. Aunque la terapia con IECA y betabloqueadores parece tener un impacto en la recuperación de la función ventricular en pacientes con esta condición, se requieren estudios adicionales para establecer el mejor manejo farmacológico.
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Abstract Background: Functional neuroimaging studies may aid to our understanding of the pathophysiology of the takotsubo cardiomyopathy. Objective: The aim of the study was to review the available evidence of brain functional connectivity in takotsubo cardiomyopathy patients. Methods: This was a systematic review. We searched MEDLINE, LILACS, Ovid (Cochrane), Scopus, and Science Direct for studies conducting functional magnetic resonance imaging (fMRI) in takotsubo patients. After reviewing title/abstract and full text, we selected relevant studies, extracted methodological characteristics, and their main findings, and assessed their risk of bias with the Newcastle-Ottawa scale. We present a narrative review. Results: We included five case-control studies from 600 registries. The risk of bias was low; comparability was the main issue. Resting-state fMRI findings suggest significant differences for the hippocampus, the Insula, the amygdala, and the para-hippocampal gyrus. Task fMRI findings suggest significant differences for the Insula, the superior occipital gyrus, and the amygdala. Studies were heterogeneous about the laterality and directionality of these differences. Conclusion: Brain connectivity alterations involving elements relevant for autonomic control like the Insula and the Amygdala provide evidence in favor of the role of functional networks in the neurocardiology of stress-related cardiomyopathies. However, it is not possible to determine if this role is causal or consequential.
Resumen Antecedentes: Los estudios de neuroimagen funcional podrían ayudar a clarificar la fisiopatología de la miocardiopatía de takotsubo. Objetivo: Revisar la evidencia disponible sobre conectividad funcional cerebral en pacientes con cardiomiopatía de takotsubo. Métodos: Revisión sistemática. Se buscaron en MEDLINE, LILACS, Ovid (Cochrane), Scopus, y ScienceDirect estudios de imagen por resonancia magnética funcional (IRMf) en pacientes con cardiomiopatía de takotsubo. Tras revisar títulos, resúmenes y textos completos se seleccionaron los estudios relevantes, se extrajeron sus características metodológicas y resultados principales, y se valoró su riesgo de sesgo mediante la escala Newcastle-Ottawa. Se presenta revisión narrativa de los resultados. Resultados: Se incluyeron cinco estudios de casos y controles de entre 600 registros. El riesgo de sesgo fue bajo, la comparabilidad fue la principal limitante. Los estudios de IRMf en estado de reposo sugieren diferencias significativas en el Hipocampo, la Ínsula, la Amígdala y el Giro parahipocampal. Los estudios de IRMf bajo paradigma sugieren diferencias en la Ínsula, el Giro occipital superior y en la Amígdala. Los estudios fueron heterogéneos respecto a la lateralización y direccion de estas diferencias. Conclusión: Alteraciones en la conectividad cerebral de zonas relevantes para el control autonómico como la ínsula y la Amígdala provén evidencia a favor del rol de redes funcionales en la neurocardiología de miocardiopatías relacionadas con el estrés. Sin embargo, aún no es posible determinar si esto obedece a un rol causal o consecuencial.
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An 82-year-old woman, Katz A, with a history of type 2 diabetes mellitus and high blood pressure, was admitted for ischemic stroke complicated by Takotsubo´s syndrome with subsequent readmission for atrial fibrillation after discharge. These three clinical events have criteria to be integrated as a Brain Heart Syndrome, which is a high-risk condition for mortality.
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Takotsubo syndrome is an acute heart disease usually triggered by significant emotional or physical stress, very occasionally described in association with natural disasters such as earthquakes. Clinically, it simulates an acute myocardial infarction with similar symptoms, laboratory tests, and electrocardiographic changes. Coronary angiography shows the absence of significant coronary disease. We report two women, aged 71 and 80 years, and who developed a Takotsubo syndrome after an earthquake. In both, the syndrome was diagnosed with cardiac magnetic resonance imaging.
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Humanos , Feminino , Cardiomiopatia de Takotsubo/etiologia , Cardiomiopatia de Takotsubo/diagnóstico por imagem , Terremotos , Infarto do Miocárdio/diagnóstico , Angiografia Coronária , EletrocardiografiaRESUMO
Takotsubo cardiomyopathy (TCM) is a condition characterized by reversible left ventricular dysfunction. TCM usually has a good prognosis but, in rare situations, it can be associated with life-threatening arrhythmias. We report a case and the management of TCM with a high-grade AV block and QT prolongation followed by ventricular fibrillation.
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El Síndrome de Takotsubo es una disfunción ventricular aguda reversible en ausencia de obstrucción coronaria. Una mujer de 85 años de edad con antecedentes de reemplazo valvular aórtico transcatéter, ingresó por dos semanas de dolor severo por una cadera desplazada por osteosíntesis fallida. Mientras se programaba para cirugía, se documentó hiponatremia severa secundaria a secreción inapropiada de hormona antidiurética. Súbitamente desarrolló edema agudo pulmonar. El ecocardiograma confirmó una válvula protésica funcional y aquinesia medial y apical de las paredes del ventrículo izquierdo. Recibió tratamiento con ventilación mecánica no invasiva, restricción de líquidos y diuréticos. La hiponatremia y la cardiomiopatía resolvieron.Takotsubo syndrome is a form of acute reversible left ventricular dysfunction in the absence of coronary obstruction. An 85-year-old lady with a medical history of transcatheter aortic valve replacement was readmitted complaining of 2 weeks of severe pain by a displaced hip and failed osteosynthesis. While she was scheduled for hip surgery, severe hyponatremia secondary to inappropriate antidiuretic hormone secretion was documented, and sudden-onset pulmonary edema ensued. Echocardiography confirmed normally functioning aortic prosthetic valve and classical features of Takotsubo. She was treated with non-invasive mechanical ventilation, water restriction, and diuretics. Hyponatremia and the cardiomyopathy resolved and the patient recovered completely.
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Cardiomiopatias , Cardiomiopatia de Takotsubo , Idoso de 80 Anos ou mais , Feminino , Humanos , Estudos Retrospectivos , Cardiomiopatia de Takotsubo/etiologia , VasopressinasRESUMO
Resumen La cardiomiopatía de Takotsubo es una entidad caracterizada por disfunción ventricular aguda y transitoria, la cual está generalmente relacionada a un evento desencadenante (estrés emocional o físico) y que, por lo general, se presenta con disfunción sistólica regional del ventrículo izquierdo, aunque hasta en un 30% puede ser biventricular. Según su severidad, en algunos casos puede condicionar choque cardiogénico refractario a manejo con inotrópicos y vasopresores, por lo que para estos casos deben considerarse los dispositivos de asistencia circulatoria. Presentamos el caso de una paciente joven a quien se realizó cambio valvular pulmonar con prótesis biológica, la cual siete semanas posteriores a la cirugía acudió al servicio de urgencias con derrame pericárdico y fisiología de tamponade secundario a síndrome pospericardiotomía. Por tal motivo se le practicó ventana pericárdica, sin embargo durante el transquirúrgico presentó cardiomiopatía de Takotsubo biventricular que le condicionó choque cardiogénico con insuficiencia mitral y tricúspidea severas y refractariedad a tratamiento médico, así como a balón intraaórtico de contrapulsación (BIAC), por lo cual requirió soporte circulatorio con ECMO venoarterial durante 5 días.
Abstract Takotsubo cardiomyopathy is an entity characterized by acute and transient ventricular dysfunction, which is usually related to a triggering event (emotional or physical stress), and usually presents with regional systolic dysfunction of the left ventricle, however up to 30% may be biventricular. Depending on its severity in some cases the disease can condition refractory cardiogenic shock to management with inotropics and vasopressors, so for these cases circulatory assistance devices should be considered. We present the case of a young patient who had pulmonary valve change with biological prosthesis, which seven weeks after surgery went to the emergency department with pericardial effusion and tamponade physiology secondary to postpericardiotomy syndrome. For this reason pericardial window was practiced, however during the procedure she presented biventricular Takotsubo cardiomyopathy which conditioned cardiogenic shock with severe mitral and tricuspid regurgitation, and refractivity to medical treatment as well as intraaortic balloon pump, requiring circulatory support with venoarterial ECMO for 5 days.
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Humanos , Feminino , Adulto , Oxigenação por Membrana Extracorpórea , Cardiomiopatia de Takotsubo/terapiaRESUMO
Takotsubo syndrome - also known as broken-heart syndrome, Takotsubo cardiomyopathy, and stress-induced cardiomyopathy - is a recently discovered acute cardiac disease first described in Japan in 1991. This review aims to update understanding on the epidemiology, pathophysiology, clinical presentation, diagnosis, and treatment of Takotsubo syndrome, highlighting aspects of interest to cardiologists and general practitioners.