| Apical ballooning syndrome or takotsubo cardiomyopathy: a systematic review. | |
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MedLine Citation:
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PMID: 16720686 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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AIMS: To clarify the major features of the apical ballooning syndrome, we performed a systematic review of the existing literature. METHODS AND RESULTS: Review of all relevant case series using the MEDLINE and EMBASE databases resulted in the identification of 14 studies. These studies suggest that the apical ballooning syndrome accounts for approximately 2.0% of ST-segment elevation infarcts, with most cases described in post-menopausal women. The most common clinical presentations are chest pain and dyspnoea, reported in 67.8 and 17.8% of the patients, respectively. Cardiogenic shock (4.2% of the patients) and ventricular fibrillation (1.5%) were not infrequent. ST-segment elevation was reported in 81.6% of the patients, T wave abnormalities in 64.3%, and Q waves in 31.8%. Cardiac biomarkers were usually mildly elevated, as reported in 86.2% of the patients. Typically, patients had left ventricular (LV) dysfunction on admission, with mean ejection fraction ranging from 20 to 49%. However, over a period of days to weeks, all patients experienced dramatic improvement in LV function. The onset of symptoms was often preceded by emotional (26.8%) or physical stress (37.8%). Norepinephrine concentration was elevated in 74.3% of the patients. Prognosis was generally excellent, with full recovery in most patients. In-hospital mortality was 1.1%. Only 3.5% of the patients experienced a recurrence. CONCLUSION: Clinicians should consider this syndrome in the differential diagnosis of patients presenting with chest pain, especially in post-menopausal women with a recent history of emotional or physical stress. |
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Authors:
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Monica Gianni; Francesco Dentali; Anna Maria Grandi; Glen Sumner; Rajesh Hiralal; Eva Lonn |
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Publication Detail:
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Type: Journal Article; Review Date: 2006-05-23 |
Journal Detail:
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Title: European heart journal Volume: 27 ISSN: 0195-668X ISO Abbreviation: Eur. Heart J. Publication Date: 2006 Jul |
Date Detail:
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Created Date: 2006-06-20 Completed Date: 2007-03-15 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 8006263 Medline TA: Eur Heart J Country: England |
Other Details:
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Languages: eng Pagination: 1523-9 Citation Subset: IM |
Affiliation:
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Department of Clinical Medicine, University of Insubria, Varese, Italy. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adult Aged Aged, 80 and over Angina Pectoris / etiology Biological Markers / blood Cardiomyopathies / diagnosis* Diagnosis, Differential Dyspnea / etiology Echocardiography Humans Middle Aged Myocardial Infarction / diagnosis* Prognosis Syndrome Ventricular Dysfunction, Left / etiology |
| Chemical | |
Reg. No./Substance:
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0/Biological Markers |
| Comments/Corrections | |
Comment In:
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Eur Heart J. 2006 Dec;27(23):2907-8; author reply 2908
[PMID:
17068006
]
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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