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Front. Neurol. | doi: 10.3389/fneur.2019.00917

Takotsubo Cardiomyopathy - Acute cardiac dysfunction associated with neurological and psychiatric disorders

  • 1Humboldt University of Berlin, Germany

Takotsubo cardiomyopathy (TTC) is an acute and reversible cardiac wall motion abnormality of the left myocardium. Although many studies focused on etiology, diagnostic and treatment of TTC, precise clinical guidelines on takotsubo cardiomyopathy are not available. Research revealed emotional and physical triggering factors of TTC and emphasized the association of TTC with psychiatric and particularly acute neurological disorders. Similar clinical presentation of acute coronary syndrome (ACS) and TTC patients, makes an anamnestic screening for TTC risk factors necessary. In psychiatric anamnesis affective disorders and chronic anxiety disorders are presumably for TTC. Subarachnoid hemorrhages and status epilepticus are typical acute neurological associated with a higher risk for TTC. Moreover, magnetic resonance imaging (MRI) studies reveled brain alterations of the limbic system and reduced connectivity of central autonomic nervous system structures. Diagnosis of TTC is made by elevation of cardiac enzymes, electrocardiogram (ECG) and visualization of myocardial wall motion. Major differential diagnoses like acute coronary syndrome and myocarditis are hereby in synopsis with anamnesis with respect of possible emotional and physical triggering factors of TTC ruled out. In most cases the TTC typical wall motion abnormalities resolve in weeks and therapy is only necessary in hemodynamic instable patients and if rare complications, like cardiac wall ruptures occur. Recently, the two-parted International expert consensus document on Takotsubo syndrome was published, providing a detailed characterization of TTC and allows clinicians to understand this cardiac dysfunction with a multidisciplinary view. complications, like cardiac wall ruptures occur. Recently, the two-parted International expert consensus document on Takotsubo syndrome was published, providing a detailed characterization of TTC and allows clinicians to understand this cardiac dysfunction with a multidisciplinary view.

Keywords: Takotsubo (stress) cardiomyopathy, Autonomic (vegetative) nervous system, Psychiatric discorders, neurological disorders, affective disorder

Received: 14 Jan 2019; Accepted: 07 Aug 2019.

Edited by:

Timo Siepmann, Universitätsklinikum Carl Gustav Carus, Germany

Reviewed by:

Rose M. Silva, Federal Institute of Minas Gerais, Brazil
Pietro Enea Lazzerini, University of Siena, Italy  

Copyright: © 2019 Buchmann and Lehmann. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

* Correspondence: Mrs. Sylvia J. Buchmann, Humboldt University of Berlin, Berlin, Germany, sylviajbuchmann@gmail.com