Beware: Newly recognized heart cardiomyopathy is not always benign

March 9, 2013

Even though a newly recognized cardiomyopathy, which mainly impacts women, is typically treatable, Tako-tsubo cardiomyopathy can also be deadly when compounded by other co-morbidities, such as heart failure, according to a study being presented March 9 at the American College of Cardiology (ACC) Scientific Sessions.

This condition, formally known as Tako-tsubo (TTC) and informally known as or , has abrupt onset of symptoms and is characterized by a distinctive left ventricular (LV) contraction profile. Ninety percent of the time, this condition affects women, who are usually middle aged and older, and the condition usually is triggered by a .

"Although TTC is typically reversible and considered to have favorable clinical outcomes, we have identified an important subset of patients, particularly those with severe and hypotension, who can have a substantial ," says the study's lead author Scott W. Sharkey, MD, a research cardiologist at the Minneapolis Heart Institute Foundation and a physician at the Minneapolis Heart Institute at Abbott Northwestern Hospital in Minneapolis. "It's also important that physicians are aware this is not a rare a condition, as it is present in nearly 10 percent of women who present to the hospital with suspected heart attacks."

MHIF researchers reviewed 250 TTC patients who presented to the Minneapolis Heart Institute at Abbott Northwestern Hospital between 2001 and 2012. Then, they segregated those TTC patients presenting with particularly severe heart failure and very low pressure, or hypotension ( < 100 mm Hg), who required supportive treatment.

They found that severe hypotensive heart failure occurred in 45 patients. In this subset, 9 female patients died in-hospital despite intervention, representing the only TTC-related hospital deaths in the 250 patient cohort.

Therefore, Sharkey and his colleagues concluded that TTC is not necessarily a benign condition. Severe hypotensive heart failure of severity necessitating vasopressor and/or intra-aortic balloon pump occurs in nearly 20 percent of patients. Also, all TTC-related hospital deaths occurred in the hypotensive heart failure subgroup with an overall mortality of 3.5 percent.

Importantly, triggering physical stressors related to severe co-morbid non-cardiac conditions (8) or advanced age (1) were present in all 9 non-survivors, Sharkey notes.

"Unfortunately, there are not any guidelines or criteria to instruct diagnosis and treatment of these patients at this time," says Sharkey. "Therefore, this study could be a starting point for this process, as it provides a more complete profile of the clinical spectrum of TTC and provides useful guidance for the effective management of these acutely ill patients."

To raise additional awareness and improve care of these patients, he adds that guidelines would be helpful at this time, in order to standardize diagnosis and treatment across varied healthcare settings.

Explore further: Hypothermia remains effective in cardiac arrest patients with preexisting cardiomyopathy

Related Stories

Hypothermia remains effective in cardiac arrest patients with preexisting cardiomyopathy

November 14, 2011
Cardiomyopathy is common among cardiac arrest survivors. The survival and neuroprotective benefits of therapeutic hypothermia is similar in patients with preexisting cardiomyopathy, compared with those patients without cardiomyopathy, ...

Chronic right ventricular pacing works for ICD patients with left ventricular dysfunction

March 26, 2012
Cardiac resynchronization therapy with defibrillators (CRT-D) is appropriate for patients who have left ventricular dysfunction and require chronic ventricular pacing, based on the findings of an observational study that ...

'Broken heart syndrome' protects the heart from adrenaline overload

June 27, 2012
A condition that temporarily causes heart failure in people who experience severe stress might actually protect the heart from very high levels of adrenaline, according to a new study published in the journal Circulation. ...

HF patients treated by a cardiologist, rather than hospitalist, have fewer readmissions

November 6, 2012
When a cardiologist attends to heart failure patients, even when the severity of illness is higher, patients have reduced rates of hospital readmissions, compared with those patients who are treated by a hospitalist, according ...

Recommended for you

New molecule may hold the key to triggering the regeneration and repair of damaged heart cells

August 21, 2017
New research has discovered a potential means to trigger damaged heart cells to self-heal. The discovery could lead to groundbreaking forms of treatment for heart diseases. For the first time, researchers have identified ...

Researchers investigate the potential of spider silk protein for engineering artificial heart

August 18, 2017
Ever more people are suffering from cardiac insufficiency, despite significant advances in preventing and minimising damage to the heart. The main cause of reduced cardiac functionality lies in the irreversible loss of cardiac ...

Lasers used to detect risk of heart attack and stroke

August 18, 2017
Patients at risk of heart attacks and strokes may be spotted earlier thanks to a diagnosis tool that uses near-infrared light to identify high-risk arterial plaques, according to research carried out at WMG, University of ...

Cholesterol crystals are sure sign a heart attack may loom

August 17, 2017
A new Michigan State University study on 240 emergency room patients shows just how much of a role a person's cholesterol plays, when in a crystallized state, during a heart attack.

How Gata4 helps mend a broken heart

August 15, 2017
During a heart attack, blood stops flowing into the heart; starved for oxygen, part of the heart muscle dies. The heart muscle does not regenerate; instead it replaces dead tissue with scars made of cells called fibroblasts ...

Injectable tissue patch could help repair damaged organs

August 14, 2017
A team of U of T Engineering researchers is mending broken hearts with an expanding tissue bandage a little smaller than a postage stamp.

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.