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Different Clinical Features between Definite and Possible Takotsubo Syndrome in a Tertiary Referral Hospital
- Source :
- Cardiology. 147:154-164
- Publication Year :
- 2021
- Publisher :
- S. Karger AG, 2021.
-
Abstract
- Background: Although imaging examination to exclude coronary artery disease (CAD) is an indispensable step for a definite diagnosis of takotsubo syndrome (TTS), this step may be overlooked in a substantial proportion of patients with secondary TTS admitted to a tertiary hospital. However, the clinical profiles and outcomes of these patients with “possible TTS” have rarely been investigated. Methods: Among 420 consecutive TTS patients with characteristic transient ventricular ballooning on repeated echocardiography, 244 patients (58.1%) who underwent an imaging study for CAD were diagnosed with “definite TTS,” whereas the remaining 176 were designated with “possible TTS.” Results: Overall, hypoxia (67.6%) and dyspnea (55.5%) were predominant presentations. The possible group was characterized by higher prevalence of male gender (46.6% vs. 35.2%, p = 0.019), secondary TTS (97.2% vs. 86.5%, p < 0.001), cancer (43.2% vs. 29.1%, p = 0.003), sepsis (46.0% vs. 32.0%, p = 0.003), and nonapical ballooning pattern (30.7% vs. 21.3%, p = 0.001) with less common ST-segment elevation on electrocardiogram (18.8% vs. 34.0%, p = 0.001). The possible group showed higher frequency of mechanical ventilation (56.2% vs. 40.2%, p = 0.001), pulmonary edema (72.2% vs. 61.5%, p = 0.023), and shock management (70.5% vs. 54.1%, p = 0.001) with similar in-hospital mortality (17.2% vs. 17.0%, p = 0.964). Conclusions: In real-world clinical practice, coronary evaluation for strict diagnosis of TTS is not frequently feasible. Addition of the possible group without coronary evaluation to the clinical spectrum of TTS would be helpful for fair estimation of clinical implication of TTS.
- Subjects :
- Mechanical ventilation
Takotsubo syndrome
medicine.medical_specialty
business.industry
medicine.medical_treatment
Imaging study
Tertiary referral hospital
medicine.disease
Pulmonary edema
Sepsis
Coronary artery disease
Internal medicine
medicine
Pharmacology (medical)
Cardiology and Cardiovascular Medicine
business
Male gender
Subjects
Details
- ISSN :
- 14219751 and 00086312
- Volume :
- 147
- Database :
- OpenAIRE
- Journal :
- Cardiology
- Accession number :
- edsair.doi...........41b70e79c87e79b9b413c76518cfb209