Takotsubo Cardiomyopathy refer to a consideration where the kernel muscles are suddenly weaken due to sudden magnification following penetrative emphasis occurrence but the nub brawn use reverts to the normal condition in a few week . It is also known as apical ballooning syndrome or broken heart syndrome . It dissemble women of postmenopausal eld and presents with features that mimic aheart attacki.e.chest pain , breathlessnessand cardiopulmonary deficiency . Unlike the ischemic disease takotsubo cardiomyopathy move up from stresses such as severe pain , domestic violence , serious malady , bad news , acute fright or financial strain . It is therefore the part of the Dr. to differentiate takotsubo cardiomyopathy ( TCM ) from myocardial infarct as the discourse glide path would be different .
The disease occurs comply an acute stressful state that leads to the release of catecholamines and as a result there is stimulation of the β2 adrenoceptor footpath . This bring on acute myocardial excitation that is consanguine to myocardia infarction and the cardiac muscularity shift to the glucose pathway as the source of energy as seen with ischaemia lead to damage of the sum muscles . The inflammation causes two-sided focal myocytosis and some mortification of the ventricular muscles .
Relationship between Takotsubo Cardiomyopathy and Troponin
Diagnosis of Takotsubo cardiomyopathy and the Value of Troponin Levels in its Diagnosis
As seen with heart tone-beginning , diagnosis of takotsubo cardiomyopathy entails :
Electrocardiography ( ECG):The electrical bodily function of the meat is monitored and since there are necrotic lesions waves of injury and/or end is evident . Therefore , one may see ST wave EL , T wafture inversions or Q waves . takotsubo cardiomyopathy features on ECG are more consistent with ST pinnacle myocardial infarction ( STEMI ) .
Echocardiography:2 - Dimensional echocardiography identify an abnormally shaped heart secondary to dilatation . There is a periapical area of hypokinesis or akinesia . These determination may also be seen in myocardial infarction and thus do not in full separate the two condition .
Coronary Angiogram : Introduction of contrast to the coronary vessels to identify any clogging lesions plat an angiogram with normal patency as the disease is stress induced and not ischaemic . The angiogram however may show an adapted shape and dilated heart chambers suggesting that Takotsubo cardiomyopathy is more likely . A major limitation of the mental testing is that it is invasive and thus would not be preferred by many patient role .
Troponin Levels and other Cardiac Markers : Blood work up for cardiac marker looks like the most significant test in diagnosing and follow - up of these patients . Troponin I and Troponin T are elevated in almost all patients with takotsubo cardiomyopathy . excitement and death causes expiration of these biomarkers into circulation hence their high level .
Conclusion
Takotsubo cardiomyopathy is a disease with indistinguishable features to myocardial infarction with a lonesome differentiating factor that takotsubo cardiomyopathy is reversible and hence aggressive management is rarely require . On the other hired man , timely interposition is needed for myocardial infarct to deliver ischemic areas and ward off further necrosis . A clinician should note that most tests carried out have indistinguishable findings to aside from angiography that is not a desire symptomatic tryout . Cardiac markers such as Brain natriuretic peptide ( BNP ) , troponin I and troponin T are elevated in more than 90 % of the case of takotsubo cardiomyopathy .
Also Read :
