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Proposed Mayo Clinic criteria for the diagnosis of Tako-Tsubo cardiomyopathy and long-term prognosis

Mayo-Klinik-Diagnosekriterien und Langzeitprognose der Tako-Tsubo-Kardiomyopathie

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Abstract

Tako-Tsubo cardiomyopathy (TTC) is a reversible cardiomyopathy with a clinical presentation indistinguishable from myocardial infarction. TTC is estimated to represent 1%–2% of patients presenting with acute myocardial infarction. It most commonly occurs in postmenopausal women and is frequently precipitated by a stressful event. Chest pain and dyspnea are the typical presenting symptoms. Transient ST-segment elevation on ECG and a small rise in cardiac biomarkers are common. Characteristic wall motion abnormalities extend beyond the territory of a single epicardial coronary artery in the absence of obstructive coronary lesions. Supportive treatment leads to spontaneous rapid recovery in nearly all patients. The prognosis is excellent, and recurrence occurs in < 10% of patients. In this article, we review the clinical features of TTC that form the basis of the Mayo Clinic diagnostic criteria, as well as the long-term prognosis for this type of cardiomyopathy.

Zusammenfassung

Die Tako-Tsubo-Kardiomyopathie (TTC) ist eine reversible Kardiomyopathie, deren klinische Symptome jenen des akuten Myokardinfarkts gleichen. Eine TTC liegt schätzungsweise bei 1–2% der Patienten vor, die Symptome eines akuten Myokardinfarkts zeigen. Betroffen sind überwiegend Frauen in der Postmenopause; in vielen Fällen geht ein Stressereignis voraus. Brustschmerzen und Luftnot sind typische Symptome. Zu den häufigen Befunden zählen transiente ST-Streckenhebungen im EKG und gering erhöhte kardiale Marker. Die charakteristischen Wandbewegungsstörungen können nicht dem Versorgungsgebiet einer einzelnen epikardialen Koronararterie zugeordnet werden bei gleichzeitiger Abwesenheit atherosklerotischer Koronarläsionen. Eine supportive Behandlung unterstützt die rasche spontane Genesung fast aller Betroffenen. Die Prognose der TTC ist somit sehr gut; Rezidive kommen in weniger als 10% der Fälle vor. In der vorliegenden Arbeit werden die klinischen Charakteristika der TTC auf der Basis der Diagnosekriterien der Mayo-Klinik vorgestellt und die Langzeitprognose der Erkrankung erörtert.

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Correspondence to A. Prasad MD.

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Madhavan, M., Prasad, A. Proposed Mayo Clinic criteria for the diagnosis of Tako-Tsubo cardiomyopathy and long-term prognosis. Herz 35, 240–244 (2010). https://doi.org/10.1007/s00059-010-3339-x

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  • DOI: https://doi.org/10.1007/s00059-010-3339-x

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