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Is Tako-tsubo syndrome in the postpartum period a clinical entity different from peripartum cardiomyopathy?
MedLine Citation:
PMID:  23519095     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
AIMS: To conduct a systematic review of case reports about Tako-tsubo syndrome (TTS) after delivery in order to assess whether TTS in the postpartum period is a peculiar entity or only a variant form of peripartum cardiomyopathy. METHODS: We performed a systematic literature search on the occurrence of TTS after Cesarean section or spontaneous delivery using the scientific literature databases Medline, EMBASE and the Cochrane library. We selected 14 case reports in English. Primary/elective cesarean section or spontaneous delivery; absence of preexisting cardiovascular disease or fetal malformations; identification of diagnostic criteria for TTS; onset of TTS symptoms after delivery were the inclusion criteria. RESULTS: Fifteen cases were selected. Cesarean section 24 h before the onset of TTS was reported in 13. All patients presented dyspnea or chest pain. The majority had mild troponin elevation, non-ST-segment elevation. Apical ballooning was observed in 60% of cases, midventricular ballooning in 33%, basal ballooning in 7%. Although 13 patients experienced acute cardiac complications (pulmonary edema, cardiogenic shock, cardiac arrest), in all left ventricular systolic function normalized within 13.43 ± 10.96 days. CONCLUSION: Women in the postpartum period, notably after Cesarean delivery, may represent another new vulnerable group at increased risk for TTS. TTS in the postpartum period should be considered a clinical entity different from peripartum cardiomyopathy with specific clinical, therapeutic and prognostic implications.
Authors:
Rodolfo Citro; Roberta Giudice; Marco Mirra; Raffaele Petta; Cesare Baldi; Eduardo Bossone; Federico Piscione
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2013-3-20
Journal Detail:
Title:  Journal of cardiovascular medicine (Hagerstown, Md.)     Volume:  -     ISSN:  1558-2035     ISO Abbreviation:  J Cardiovasc Med (Hagerstown)     Publication Date:  2013 Mar 
Date Detail:
Created Date:  2013-3-22     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101259752     Medline TA:  J Cardiovasc Med (Hagerstown)     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
a'Cuore' Department, University Hospital 'San Giovanni di Dio e Ruggi d'Aragona', Salerno bU.O.C. 'Gravidanza a rischio e Diagnosi Prenatale', University Hospital 'San Giovanni di Dio e Ruggi d'Aragona', Salerno, Italy.
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