Takotsubo syndrome in young fertile women

Role of Positive Emotions in Takotsubo Cardiomyopathy

Takotsubo Cardiomyopathy, also known as "broken heart syndrome," is a transient cardiac condition characterized by sudden left ventricular dysfunction, often triggered by emotional stress or significant life events. While research has predominantly focused on the impact of negative emotions and emotional stressors, there is a growing interest in understanding the role of positive emotions in this unique cardiac syndrome. This narrative review explores the emerging research on positive emotions and Takotsubo Cardiomyopathy. It provides an overview of studies investigating the relationship between positive emotions and the condition, highlighting key findings and observations. Positive emotions, such as joy, happiness, gratitude, and optimism, have been associated with improved emotional well-being, better-coping mechanisms, and potential cardiovascular protection. Some studies suggest that individuals experiencing higher levels of positive emotions may have a reduced risk of developing Takotsubo Cardiomyopathy. However, the research in this area is still limited, with small sample sizes and challenges in quantifying positive emotions. Additionally, the interplay between positive and negative emotions requires further exploration to fully understand their impact on cardiovascular health. Despite these limitations, harnessing positive emotions in cardiac care holds promise for enhancing patient outcomes and emotional well-being. Integrating positive psychology into clinical practice and cardiac rehabilitation may lead to more holistic and patient-centered approaches to cardiovascular care. Further longitudinal studies, interventional trials, and mechanistic investigations are needed to strengthen the evidence base and identify potential therapeutic perspectives. As research progresses, addressing these gaps will provide valuable insights into the complex relationship between emotions and cardiovascular health, benefiting patients affected by Takotsubo Cardiomyopathy and other cardiovascular conditions.

Age-sex effect on in-hospital complications and mortality in patients with Takotsubo syndrome. Insights from the National Inpatient Sample

Age and sex differences in Takotsubo syndrome (TTS) are still a matter of debate. The present study aimed to evaluate the difference in cardiovascular (CV) risk factors, CV disease, in-hospital complications, and death within different sex-age groups. Using the National Inpatient Sample database between 2012 and 2016, 32,474 patients older than 18 years of age hospitalized with the primary diagnosis of TTS were identified. A total of 32,474 patients were enrolled; 27,611 (85.04%) were female. CV risk factors were higher in females, while CV diseases and in-hospital complications were significantly higher in males. The mortality in males was twice as high as that of female patients (9.83% versus 4.58%, p<0.01), and in the logistic regression model after adjustment for confounders, the odds ratio (OR) was 1.79, the confidence interval was 1.60-2.02, and p<0.01. After dividing the group based on age, in-hospital complications were inversely related to age in both sexes, and the length of in-hospital stay was double in the youngest group compared to the oldest one. Mortality increased progressively with age in both groups but was constantly higher in males for each age group. Multiple logistic regression analysis for mortality was performed for the two sexes separately and for the three age groups, considering the youngest one as the reference group. In females, the OR was 1.59 and 2.88, respectively, for groups 2 and 3; for males, the OR was 1.92 and 3.15, all of them statistically significant (p<0.01). In-hospital complications were more common in younger patients with TTS, particularly in males. Mortality was positively correlated with age for both sexes, but mortality was higher in males compared to females in all age groups.

Takotsubo cardiomyopathy misdiagnosed as acute myocardial infarction under the Chest Pain Center model: A case report

BACKGROUND

With the spread and establishment of the Chest Pain Center in China, adhering to the idea that “time is myocardial cell and time is life”, many hospitals have set up a standardized process that ensures that patients with acute myocardial infarction (AMI) who meet emergency percutaneous coronary intervention (PCI) guidelines are sent directly to the DSA room by the prehospital emergency doctor, saving the time spent on queuing, registration, payment, re-examination by the emergency doctor, and obtaining consent for surgery after arriving at the hospital. Takotsubo cardiomyopathy is an acute disease that is triggered by intense emotional or physical stress and must be promptly differentiated from AMI for its appropriate management.

CASE SUMMARY

A 52-year-old female patient was taken directly to the catheterization room to perform PCI due to 4 h of continuous thoracalgia and elevation of the ST segment in the V3–V5 lead, without being transferred to the emergency department according to the Chest Pain Center model. Loading doses of aspirin, clopidogrel and statins were administered and informed consent for PCI was signed in the ambulance. On first look, the patient looked nervous in the DSA room. Coronary angiography showed no obvious stenosis. Left ventricular angiography showed that the contraction of the left ventricular apex was weakened, and the systolic period was ballooning out, showing a typical “octopus trap” change. The patient was diagnosed with Takotsubo cardiomyopathy. Five days later, the patient had no symptoms of thoracalgia, and the serological indicators returned to normal. She was discharged with a prescription of medication.

CONCLUSION

Under the Chest Pain Center model for the treatment of patients with chest pain showing ST segment elevation, despite the urgency of time, Takotsubo cardiomyopathy must be promptly differentiated from AMI for its appropriate management.