1. Takotsubo cardiomyopathy is a syndrome of transient left ventricular dysfunction resulting in apical ballooning that mimics ST-elevation myocardial infarction.
2. It is typically triggered by severe emotional or physical stress and is more common in post-menopausal women.
3. While symptoms and test results can appear similar to a heart attack, coronary angiography shows no significant arterial narrowing, and left ventricular function typically recovers within weeks.
Cardiogenicshock by Dr.Afroza Prioty -140123092109-phpapp02Afroza Prioty
A small overview on cardiogenic shock which sometimes becomes a burning issue for the medical personnels and to combat the situation, the measures should be taken immediately and urgently.
Myocardial infarction (MI), commonly known as a heart attack, occurs when blood flow decreases or stops to a part of the heart, causing damage to the heart muscle. Find a good presentation on Acute myocardial infarction here.
Heart failure is a clinical syndrome characterized by dyspnea, fatigue, and clinical signs of congestion leading to frequent hospitalizations, poor quality of life, and shortened life expectancy. It is a final common pathway to various cardiac conditions. It is a growing problem worldwide with serious consequences in Sub-Saharan Africa where it occurs at a younger age with limited resources to manage the condition. The incidence and prevalence vary worldwide. In this mini-review, we looked at the definition, classification, and pathophysiology of the condition.
Cardiogenicshock by Dr.Afroza Prioty -140123092109-phpapp02Afroza Prioty
A small overview on cardiogenic shock which sometimes becomes a burning issue for the medical personnels and to combat the situation, the measures should be taken immediately and urgently.
Myocardial infarction (MI), commonly known as a heart attack, occurs when blood flow decreases or stops to a part of the heart, causing damage to the heart muscle. Find a good presentation on Acute myocardial infarction here.
Heart failure is a clinical syndrome characterized by dyspnea, fatigue, and clinical signs of congestion leading to frequent hospitalizations, poor quality of life, and shortened life expectancy. It is a final common pathway to various cardiac conditions. It is a growing problem worldwide with serious consequences in Sub-Saharan Africa where it occurs at a younger age with limited resources to manage the condition. The incidence and prevalence vary worldwide. In this mini-review, we looked at the definition, classification, and pathophysiology of the condition.
Il ruolo del Dipartimento di Management nel progetto "Destinazione Impresa"Riccardo Beltramo
Progetto Interreg IT-CH "Destinazione impresa" sul turismo d'impresa. Il Gruppo di ricerca del Dipartimento di Management ha ideato la metodologia per la selezione delle imprese, la conduzione delle visite e l'organizzazione di pacchetti turistici per scoprire i territori che forniscono risorse alle imprese piemontesi.
Stattys dezvoltă și comercializează instrumente de comunicare, versatile, mobile, ușoare și metode de business pentru cursuri, training-uri și evenimente, coaching, project management, strategii de business, prezentări, ședințe, facilitare grafică.
Takotsubo cardiomyopathy, also known as "broken heart syndrome," is a temporary heart condition that mimics a heart attack. It's typically triggered by intense emotional or physical stress, causing a sudden weakening of the heart muscle. Symptoms can include chest pain, shortness of breath, and irregular heartbeats. The condition usually resolves on its own within days to weeks, and treatment focuses on managing symptoms and addressing the underlying stressors.
Cardiology 1.3. Syncope - by Dr. Farjad IkramFarjad Ikram
Introduction to one of the more challenging symptoms to investigate. Syncope is transient loss of consciousness with loss of postural tone due to diffuse hypoperfusion of cerebral cortex, followed by rapid, complete and spontaneous recovery.
Template design credits - http://www.slidescarnival.com
The medicos PDF app was used to collect this information. I stumbled discovered this amazing app when searching for various slides and books and decided to share it with you all. The Google Play Store has a free version of the app.
Importance for learners:
MBBS/Dental
Nursing
Pharmacy
Microbiology
BPH
MPH
MDS
MD
Ophthalmology
Paramedics
Explore natural remedies for syphilis treatment in Singapore. Discover alternative therapies, herbal remedies, and lifestyle changes that may complement conventional treatments. Learn about holistic approaches to managing syphilis symptoms and supporting overall health.
Title: Sense of Smell
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
Ethanol (CH3CH2OH), or beverage alcohol, is a two-carbon alcohol
that is rapidly distributed in the body and brain. Ethanol alters many
neurochemical systems and has rewarding and addictive properties. It
is the oldest recreational drug and likely contributes to more morbidity,
mortality, and public health costs than all illicit drugs combined. The
5th edition of the Diagnostic and Statistical Manual of Mental Disorders
(DSM-5) integrates alcohol abuse and alcohol dependence into a single
disorder called alcohol use disorder (AUD), with mild, moderate,
and severe subclassifications (American Psychiatric Association, 2013).
In the DSM-5, all types of substance abuse and dependence have been
combined into a single substance use disorder (SUD) on a continuum
from mild to severe. A diagnosis of AUD requires that at least two of
the 11 DSM-5 behaviors be present within a 12-month period (mild
AUD: 2–3 criteria; moderate AUD: 4–5 criteria; severe AUD: 6–11 criteria).
The four main behavioral effects of AUD are impaired control over
drinking, negative social consequences, risky use, and altered physiological
effects (tolerance, withdrawal). This chapter presents an overview
of the prevalence and harmful consequences of AUD in the U.S.,
the systemic nature of the disease, neurocircuitry and stages of AUD,
comorbidities, fetal alcohol spectrum disorders, genetic risk factors, and
pharmacotherapies for AUD.
ARTIFICIAL INTELLIGENCE IN HEALTHCARE.pdfAnujkumaranit
Artificial intelligence (AI) refers to the simulation of human intelligence processes by machines, especially computer systems. It encompasses tasks such as learning, reasoning, problem-solving, perception, and language understanding. AI technologies are revolutionizing various fields, from healthcare to finance, by enabling machines to perform tasks that typically require human intelligence.
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Anti ulcer drugs and their Advance pharmacology ||
Anti-ulcer drugs are medications used to prevent and treat ulcers in the stomach and upper part of the small intestine (duodenal ulcers). These ulcers are often caused by an imbalance between stomach acid and the mucosal lining, which protects the stomach lining.
||Scope: Overview of various classes of anti-ulcer drugs, their mechanisms of action, indications, side effects, and clinical considerations.
Ozempic: Preoperative Management of Patients on GLP-1 Receptor Agonists Saeid Safari
Preoperative Management of Patients on GLP-1 Receptor Agonists like Ozempic and Semiglutide
ASA GUIDELINE
NYSORA Guideline
2 Case Reports of Gastric Ultrasound
Couples presenting to the infertility clinic- Do they really have infertility...Sujoy Dasgupta
Dr Sujoy Dasgupta presented the study on "Couples presenting to the infertility clinic- Do they really have infertility? – The unexplored stories of non-consummation" in the 13th Congress of the Asia Pacific Initiative on Reproduction (ASPIRE 2024) at Manila on 24 May, 2024.
- Video recording of this lecture in English language: https://youtu.be/lK81BzxMqdo
- Video recording of this lecture in Arabic language: https://youtu.be/Ve4P0COk9OI
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
New Directions in Targeted Therapeutic Approaches for Older Adults With Mantl...i3 Health
i3 Health is pleased to make the speaker slides from this activity available for use as a non-accredited self-study or teaching resource.
This slide deck presented by Dr. Kami Maddocks, Professor-Clinical in the Division of Hematology and
Associate Division Director for Ambulatory Operations
The Ohio State University Comprehensive Cancer Center, will provide insight into new directions in targeted therapeutic approaches for older adults with mantle cell lymphoma.
STATEMENT OF NEED
Mantle cell lymphoma (MCL) is a rare, aggressive B-cell non-Hodgkin lymphoma (NHL) accounting for 5% to 7% of all lymphomas. Its prognosis ranges from indolent disease that does not require treatment for years to very aggressive disease, which is associated with poor survival (Silkenstedt et al, 2021). Typically, MCL is diagnosed at advanced stage and in older patients who cannot tolerate intensive therapy (NCCN, 2022). Although recent advances have slightly increased remission rates, recurrence and relapse remain very common, leading to a median overall survival between 3 and 6 years (LLS, 2021). Though there are several effective options, progress is still needed towards establishing an accepted frontline approach for MCL (Castellino et al, 2022). Treatment selection and management of MCL are complicated by the heterogeneity of prognosis, advanced age and comorbidities of patients, and lack of an established standard approach for treatment, making it vital that clinicians be familiar with the latest research and advances in this area. In this activity chaired by Michael Wang, MD, Professor in the Department of Lymphoma & Myeloma at MD Anderson Cancer Center, expert faculty will discuss prognostic factors informing treatment, the promising results of recent trials in new therapeutic approaches, and the implications of treatment resistance in therapeutic selection for MCL.
Target Audience
Hematology/oncology fellows, attending faculty, and other health care professionals involved in the treatment of patients with mantle cell lymphoma (MCL).
Learning Objectives
1.) Identify clinical and biological prognostic factors that can guide treatment decision making for older adults with MCL
2.) Evaluate emerging data on targeted therapeutic approaches for treatment-naive and relapsed/refractory MCL and their applicability to older adults
3.) Assess mechanisms of resistance to targeted therapies for MCL and their implications for treatment selection
Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journeygreendigital
Tom Selleck, an enduring figure in Hollywood. has captivated audiences for decades with his rugged charm, iconic moustache. and memorable roles in television and film. From his breakout role as Thomas Magnum in Magnum P.I. to his current portrayal of Frank Reagan in Blue Bloods. Selleck's career has spanned over 50 years. But beyond his professional achievements. fans have often been curious about Tom Selleck Health. especially as he has aged in the public eye.
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Introduction
Many have been interested in Tom Selleck health. not only because of his enduring presence on screen but also because of the challenges. and lifestyle choices he has faced and made over the years. This article delves into the various aspects of Tom Selleck health. exploring his fitness regimen, diet, mental health. and the challenges he has encountered as he ages. We'll look at how he maintains his well-being. the health issues he has faced, and his approach to ageing .
Early Life and Career
Childhood and Athletic Beginnings
Tom Selleck was born on January 29, 1945, in Detroit, Michigan, and grew up in Sherman Oaks, California. From an early age, he was involved in sports, particularly basketball. which played a significant role in his physical development. His athletic pursuits continued into college. where he attended the University of Southern California (USC) on a basketball scholarship. This early involvement in sports laid a strong foundation for his physical health and disciplined lifestyle.
Transition to Acting
Selleck's transition from an athlete to an actor came with its physical demands. His first significant role in "Magnum P.I." required him to perform various stunts and maintain a fit appearance. This role, which he played from 1980 to 1988. necessitated a rigorous fitness routine to meet the show's demands. setting the stage for his long-term commitment to health and wellness.
Fitness Regimen
Workout Routine
Tom Selleck health and fitness regimen has evolved. adapting to his changing roles and age. During his "Magnum, P.I." days. Selleck's workouts were intense and focused on building and maintaining muscle mass. His routine included weightlifting, cardiovascular exercises. and specific training for the stunts he performed on the show.
Selleck adjusted his fitness routine as he aged to suit his body's needs. Today, his workouts focus on maintaining flexibility, strength, and cardiovascular health. He incorporates low-impact exercises such as swimming, walking, and light weightlifting. This balanced approach helps him stay fit without putting undue strain on his joints and muscles.
Importance of Flexibility and Mobility
In recent years, Selleck has emphasized the importance of flexibility and mobility in his fitness regimen. Understanding the natural decline in muscle mass and joint flexibility with age. he includes stretching and yoga in his routine. These practices help prevent injuries, improve posture, and maintain mobilit
The prostate is an exocrine gland of the male mammalian reproductive system
It is a walnut-sized gland that forms part of the male reproductive system and is located in front of the rectum and just below the urinary bladder
Function is to store and secrete a clear, slightly alkaline fluid that constitutes 10-30% of the volume of the seminal fluid that along with the spermatozoa, constitutes semen
A healthy human prostate measures (4cm-vertical, by 3cm-horizontal, 2cm ant-post ).
It surrounds the urethra just below the urinary bladder. It has anterior, median, posterior and two lateral lobes
It’s work is regulated by androgens which are responsible for male sex characteristics
Generalised disease of the prostate due to hormonal derangement which leads to non malignant enlargement of the gland (increase in the number of epithelial cells and stromal tissue)to cause compression of the urethra leading to symptoms (LUTS
2. Extensive PMH
• Previous DU 1972 / 2002
• COPD
• Pernicious Anaemia
• CKD stage III
• Crohn’s Disease – previous right Hemicolectomy, underwent
laparotomy and excision of perforated recurrent ileal / ileocolic
Crohn’s plus loop ileostomy 31st August 2008
Admitted under Medicine with nausea / vomiting / high stoma
output 17 Oct 2008
Severe hyponatraemia (117mmol/L), Mg also low at 0.27, CRP
25, plts 758, Stool – giardial cysts!
Initial diagnosis
• Dehydration with electrolyte imbalance secondary to
nausea and vomiting
• Incidental giardiasis
• Crohn’s flare-up
3. Treated with IV fluids / oral magnesium / oral
metronidazole – initial good improvement
Transferred under Gastroenterologists
23 Oct 2009 – deteriorated with worsening diarrhoea /
signs of LRTI
Pyrexial, Sinus tachycardia 120bpm, BP 120/64mmHg
CRP 137, WCC 30.2, Mg 0.30, Ca 1.38
CXR – Left pneumonic consolidation
AXR – not diagnostic
Rx PO metronidazole / IV Tazocin / Mg & Ca replacement
CT Abdo – no worrying intra-abdominal pathology
4. Made slow but steady recovery over next few weeks
Due to be commenced on IV TPN 11 Nov 2009 to
improve nutritional status
Had some pain / distress during central line insertion
11 Nov 2009, then developed sudden onset malaise /
feeling of impending doom
Transient pre-syncopal episode – only lasted 1-2
mins
HR 108bpm>140bpm – SR, BP 142/62mmHg
No clinical signs of heart failure
Hb 8.0 g/dl, Cr 100, Mg 0.67, Cr 2.12
ECG
5.
6.
7.
8.
9.
10. Treated initially as Acute STEMI 11 Nov 2008
Not thrombolysed as recent major surgery / absence
of chest pain
Referred for bail-out PCI at Hull – was not accepted
due to comorbidities (main issue being significant
anaemia)
Rx Aspirin / Clopidogrel / IV Nitrates / blood
transfusion / IV fluids
Troponin I elevated at 12 hours at 1.06, then dropped
to 0.13 within 24 hours
CK not elevated at any stage – 60 maximally
No pain, but worsening dyspnoea / hypotension
despite above therapy
Coronary angiogram organised for 14 Nov 2008
11. • Showed angiographically normal wide calibre
coronary arteries with no significant flow-limitation in
any arterial segment
• Left ventriculography showed substantial LV apical
ballooning with overall mild-moderate LV impairment
and elevated LVEDP
12. Likely triggered by dramatically elevated
catecholamine levels caused by concurrent illness in
a post-menopausal woman
Rx entirely supportive
Commenced on beta-blocker / ACEI, continued on
Aspirin / SC prophylactic clexane
IV TPN continued
Continued to recover with GI supportive therapy
No further cardiac complications
Discharged home 08 Dec 2008
ECHO end Dec 2008 – Normal LV systolic function
with resolution of apical ballooning
13. No subsequent GI complications – stoma
stable with no further vomiting / stoma
problems
No further cardiac complications – no
recurrence of chest pain / cardiac failure
However, patient readmitted with
exacerbation of COPD secondary to
pseudomonal pneumonia 08 Jan 2009 –
developed Type II respiratory failure and died
in ITU 16 Jan 2009
14. Colin A J Farquharson
Consultant Cardiologist
Diana Princess of Wales
Hospital
Grimsby
United Kingdom
15. Cardiomyopathy characterized by transient apical and
midventricular LV dysfunction in the absence of
significant coronary artery disease that is triggered by
emotional or physical stress.
• In setting of depressed/abnormal function of distal and apical LV
segments there is compensatory hyperkinesis of basal walls
“ballooning” of apex during systole.
Typically recover normal LV function in 1-4 weeks.
Colin Farquharson , Cardiologist , Grimsby UK
16. 1st described in Japan in 1990
Named after the tako-tsubo,
which is an octopus trap
• Shape of the trap is similar
to the appearance of LV
apical ballooning noted in
patients with this form of
cardiomyopathy
Was later described in many
other reports and was
subsequently recognised as a
distinct entity
Colin Farquharson , Cardiologist , Grimsby UK
17. Kurisu, S., et al. 2002. American Heart Journal. 143: 448-455.
Colin Farquharson , Cardiologist , Grimsby UK
20. May account for up to 2% of suspected ACS
In-hospital mortality ranges between 0-8%
Much more common in women (~90%),
especially postmenopausal women (>80% of
cases)
Mean age 58-75 years
More common in industrialised nations
Many recognised triggers: death of loved one,
other catastrophic news, devastating financial
losses, natural disasters, physical illness/ICU,
etc.
Colin Farquharson , Cardiologist , Grimsby UK
21. 1. Transient a/dyskinesis of apical and midventricular
segments in association with regional wall motion
abnormalities that extend beyond the distribution of a
single epicardial vessel
2. Absence on angiography of obstructive coronary artery
disease or evidence of acute plaque rupture
3. New ST segment elevation or T wave inversions on
ECG
4. Absence of recent significant head trauma, intracranial
bleeding, phaeochromocytoma, myocarditis, or
hypertrophic cardiomyopathy
Proposed by Bybee, et al. 2004. Annals of Internal Medicine. 141: 858-865.
Colin Farquharson , Cardiologist , Grimsby UK
22. Emotional stress
Death or severe illness or injury of family
member, friend, pet
Receiving bad news – diagnosis of major illness,
family divorce, spouse leaving for war
Severe argument
Fear of public speaking
Involvement of legal proceedings
Financial loss – business / gambling
Car accident
Surprise party
Moving to new house
Colin Farquharson , Cardiologist , Grimsby UK
23. Non-cardiac surgery / procedure – e.g.
cholecystectomy / hysterectomy
Severe illness – asthma / COPD, connective
tissue disorders, inflammatory bowel disease
Illnesses that cause pain – fracture, renal colic,
pneumothorax, PE
Recovery from general anaesthesia
Cocaine abuse
Opiate withdrawal
Stress testing – dobutamine stress echo / MPS
Thyrotoxicosis
Colin Farquharson , Cardiologist , Grimsby UK
24. New England Journal of Medicine 2005;352:539-548
Colin Farquharson , Cardiologist , Grimsby UK
25. New England Journal of Medicine
2005;352:539-548
Colin Farquharson , Cardiologist , Grimsby UK
26. Catecholamine excess
• Norepinephrine levels are very elevated in ~75% in some studies
• Plasma catecholamines significantly higher than in cases of MI
• May induce microvascular spasm or dysfunction myocardial
stunning or direct myocardial toxicity
• Limited endomyocardial biopsy data c/w histologic signs of
catecholamine toxicity
Coronary artery spasm or microvascular spasm
Myocarditis
Post-menopausal downregulation of oestrogen
receptors
Dense distribution of cardiac adrenoceptors in LV
apex of women > men
Colin Farquharson , Cardiologist , Grimsby UK
27. Substernal chest pain (but not always)
ECG abnormalities
• ST elevation (usually anterior leads)- 82%
• ST depression
• T wave inversion
• QT prolongation
• Abnormal Q waves
Elevated cardiac biomarkers
Dyspnoea
Shock – similar haemodynamically to cardiogenic shock
Syncope / feeling of “doom”
Colin Farquharson , Cardiologist , Grimsby UK
29. Tachyarrhythmias, bradyarrhythmias
Pulmonary oedema
Cardiogenic shock
Transient LV outflow tract obstruction
Mitral valve dysfunction
Acute thrombus formation and stroke
Death
Colin Farquharson , Cardiologist , Grimsby UK
30. Because presentation is similar to ACS, management is
usually similar in initial stages.
LV ventriculogram and/or echocardiography can both be
used to visualize apical ballooning with a/dyskinesis of
apical ½ to ⅔ of the LV.
• Average LV EF range 20-49%
• Can have “atypical” ballooning of the middle or basal portions of
the LV (much less common)
• Wall motion abnormalities typically involve the distribution of more
than one coronary artery
Ventriculography and echocardiography also allow
evaluation for LV outflow tract obstruction (~16%).
Cardiac catheterization reveals lack of flow limiting
coronary lesions or evidence of plaque rupture.Colin Farquharson , Cardiologist , Grimsby UK
31. Supportive, conservative therapy
• Hydrate, remove / reduce stress (if possible)
Treat LV dysfunction with standard heart failure
regimen- including beta blocker, ACE inhibitor,
diuretics (if volume overloaded), aspirin
• Usually treated for ~6 months
For pts who are hypotensive with shock, perform
echo to evaluate for LVOT obstruction.
• No LVOT obstruction inotropes, IABP if needed
• +LVOT obstruction NO inotropes (can worsen obstruction), use
beta blockers (+/- α-agonist phenylephrine), IABP if needed
• +/- fluid resuscitation (evaluate pulmonary status)
Colin Farquharson , Cardiologist , Grimsby UK
32. 0-8% in-hospital mortality, likely closer to 1-2% if
optimally treated
Recovery of LV function, typically in 1-4 weeks
Late sudden death (rare) and recurrent disease
(<10%) have been reported
Overall, good prognosis. If
patient survives the acute
phase, long-term prognosis
is excellent.
Colin Farquharson , Cardiologist , Grimsby UK
33. ABNORMAL LV
CONTRACTION
ON DAY 1 OF
CHEST PAIN
ADMISSION
RECOVERY OF
NORMAL LV
CONTRACTION 3
MONTHS AFTER
ADMISSION
Colin Farquharson , Cardiologist , Grimsby UK
34. New England Journal of Medicine 2005;352:539-548
Colin Farquharson , Cardiologist , Grimsby UK
35. Takotsubo cardiomyopathy is a syndrome of transient
dysfunction of apical/midventricular left ventricle with
compensatory hyperkinesis of basal segment resulting in
apical ballooning.
It is always triggered by significant emotional or physical
stress.
It is much more common in post-menopausal women.
Presentation is similar to MI (symptoms, ECG changes,
and biomarker elevations). Probably accounts for ~1-2%
of suspected ACS cases
No significant coronary artery disease or evidence of
plaque rupture can be identified on coronary angio
LV function usually recovers - typically within 4 weeks.
Colin Farquharson , Cardiologist , Grimsby UK
36. Brenner, Z. R. and J. Powers. Takotsubo cardiomyopathy. 2008.
Heart & Lung. 37: 1-7.
Bybee, K. A., et al. Systematic Review: Transient Left Ventricular
Apical Ballooning: A Syndrome That Mimics ST-Segment Elevation
Myocardial Infarction. 2004. Annals of Internal Medicine. 141: 858-
865.
Celik, T., et al. Stress-induced (Takotsubo) cardiomyopathy: A
transient disorder. 2007. International Journal of Cardiology. (epub)
Prasad, A., et al. Apical ballooning syndrome (Tako-Tsubo or stress
cardiomyopathy): A mimic of acute myocardial infarction. 2008.
American Heart Journal. 155: 408-17.
Reeder, Guy S. Stress-induced (takotsubo) cardiomyopathy. 2007.
www.uptodate.com and references herein
Wittstein, I. S., et al. Neurohumoral Features of Myocardial Stunning
Due to Sudden Emotional Stress. 2005. New England Journal of
Medicine. 352(6): 539-48.
Colin Farquharson , Cardiologist , Grimsby UK