Thursday 16 July 2015

KYJ- Takotsubo cardiomyopathy

#KYJ - Takotsubo 
It was 1976 when Sir Elton John sang those famous words..."don't go breaking my heart"; to which Kiki Dee retorted, "I couldn't if I tried".

Well Elton, a broken heart is easier than you think. Broken heart syndrome or more correctly, Takotsubo cardiomyopathy is a stress induced apical ballooning and reshaping of the left ventricle, caused by stress.  Under periods of extreme stress, brought on by tragedy, life events, loss, and anxiety inducing stimuli, the myocardium undergoes a remodelling of shape. It is induced by high concentrations of stress related hormones, eg adrenaline, norepinephrine, and cortisol, released at times of stress.  Not new, this stress induced cardiomyopathy presents as an acute heart failure that mimics an Anterior MI with typical pain, and ECG changes.  It is thought to be a silent contributor to 1.5-2.5% of ACS.  
Made up of two Japanese words, "Tako" means 'octopus' and "tsubo" means trap or pot.  Literally Takotsubo means octopus pot, and it is so called because when observed the patient's heart takes on the shape of an ancient pot that the Japanese fishermen in sea side villages, used to catch octopus for food.
It was first described in the 1990s so is really a relatively new syndrome.  It was seen women, who in their 60 & 70s, lost their husbands.  Proving to be such a stress inducing life event, a statistically significant number of widows died in the months following from what was originally called Broken hearts, then stress cardiomyopathy.  On autopsy their hearts had taken on the reshaping appearance of a Takotsubo, hence its renaming.

More?? ... 

http://m.circ.ahajournals.org/content/124/18/e460.full