Stress induced cardiomyopathy presenting as XXXX : Tako-Tsubo in Mercogliano, Southern Italy.

@entity1 @entity1187 @entity662 @entity712 @entity2806 @entity117 @entity661 @entity1162 @entity1455
BACKGROUND: @entity661 ( @entity661 ) in its typical (apical) and atypical (non-apical) forms is being increasingly recognized in the West owing to early systematic coronary angiography in @entity1187 ( @entity1187 ). AIM OF THE STUDY: To assess the incidence, the clinical characteristics and the outcome of @entity661 in a single high volume cath lab in Southern Italy over the last 6 years. METHODS: Among 1674 consecutive @entity1 (pts) referred to our coronary care units in the last 6 years (2001-2006) for @entity1187 we selected 6 (0.5%) pts (6 @entity1 ; age 57 +/- 6 years) who fulfilled the following 4 criteria: 1) transient left ventricular wall motion abnormalities resulting in ballooning at contrast ventricolographic or echocardiographic evaluation; 2) normal coronary artery on coronary angiography performed 5 +/- 9 hours from hospitalization; 3) new @entity2806 (either ST-segment elevation or T-wave inversion) and 4) emotional or physical trigger event. RESULTS: At admission all pts had presumptive diagnosis of @entity1187 and ECG revealed ST elevation in 3 (50%) and T wave inversion with @entity1162 in 3 (50%). In the acute phase @entity1455 occurred in 2 (33%) and @entity712 in 1(16%). Presenting symptoms were @entity662 in 6 (100%), dyspnoea in 2 (33%) and lipotimia in 1 (16%). At echocardiographic-ventricolographic assessment, the mechanical dysfunction (ballooning) was apical in all 6 pts ("classic" @entity661 ). In all @entity1 wall motion abnormalities completely reversed within 4.5 +/- 1.5 days. The region of initial recovery was the anterior and lateral wall in 4 cases and the lateral wall in 2 cases. Ejection fraction was 35 +/- 8% in the acute phase and increased progressively at discharge (55 +/- 6%) and at 41 +/- 20 months follow-up (60 +/- 4%, p < 0.001 vs. baseline). All @entity1 remained asymptomatic with minimal ( @entity117 , beta blockers, antihypertensive and antidislipidemic therapy) treatment. CONCLUSION: Classic @entity661 is a frequent serendipitous diagnosis after coronary angiography showed "surprisingly" normal findings in a clinical setting mimicking an @entity1187 . Despite its long-term good prognosis life threatening complications in the acute phase can occur.
