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Takotsubo syndrome 

Takotsubo syndrome
Chapter:
Takotsubo syndrome
Author(s):

Rodolfo Citro

, Laurent Davin

, and Daniel Rodriguez Muñoz

DOI:
10.1093/med/9780198726012.003.0046
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date: 26 November 2020

Owing to its dynamic and unique nature, standard echocardiography plays a key role in the diagnostic work-up of patients suspected of takotsubo cardiomyopathy (TTC), providing distinctive features of this peculiar syndrome. Useful information for the early recognition of TTC can be derived from the discrepancy between extensive myocardial dysfunction and a modest increase in troponin levels; the detection of a ‘circumferential pattern’ of left ventricular (LV) wall motion abnormalities, which typically extend beyond the distribution of a single coronary artery; coronary flow assessment in the distal tract of the left anterior descending artery; and right ventricular (RV) involvement (biventricular ballooning). Advanced echocardiographic techniques, including speckle tracking, myocardial contrast and coronary flow studies, are providing further mechanistic and pathophysiological insights. Additionally, evaluation of both LV systolic and diastolic function along with early identification of any potential complications are crucial for clinical management and risk stratification. Comprehensive serial echocardiographic examinations should be systematically performed during the follow-up of TTC patients to monitor myocardial function recovery.

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