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[Takotsubo and surroundings. Step by step postpartum stress-induced cardiomyopathy shows its facet. A peculiar case of atypical takotasubo in the peripartum period].

Abstract
Takotsubo syndrome is an acquired cardiomyopathy with transient and reversible left ventricular dysfunction that can mimic an acute coronary syndrome. It is characterized by ECG abnormalities, including minimal ST-segment elevation and T-wave changes, mild troponin elevation, typical left ventricular regional wall motion abnormalities (apical ballooning) and atypical forms (midventricular or reverse apical ballooning) without significant coronary artery stenosis. Its etiology and pathophysiology remain unclear. The sympathetic system seems to play a central role: its exaggerated response to emotional or physical stress triggers may induce microvascular dysfunction and catecholamine-induced cardiotoxicity due to cyclic AMP-mediated calcium overload. We report our experience highlighting the possible pathophysiological and clinical overlap of emotional-triggered catecholamine cardiotoxicity, arterial hypertension and physiological cardiovascular overload in pregnancy describing an atypical case of takotsubo cardiomyopathy with diffuse left ventricular hypokinesia at onset and subsequent evolution to apical ballooning.
AuthorsMarco Russo, Roberta Sappa, Enrico Gianfagna, Kareem Salame, Gianfranco Sinagra, Alessandro Proclemer
JournalGiornale italiano di cardiologia (2006) (G Ital Cardiol (Rome)) Vol. 15 Issue 1 Pg. 51-5 (Jan 2014) ISSN: 1827-6806 [Print] Italy
Vernacular TitleTakotsubo e dintorni. Poco alla volta la cardiomiopatia si rivelaUn particolare caso di takotsubo atipico nel peripartum.
PMID24503735 (Publication Type: Case Reports, English Abstract, Journal Article)
Chemical References
  • Cyclic AMP
Topics
  • Adult
  • Cyclic AMP (metabolism)
  • Female
  • Humans
  • Peripartum Period
  • Pregnancy
  • Pregnancy Complications, Cardiovascular (physiopathology)
  • Stress, Psychological (complications)
  • Takotsubo Cardiomyopathy (etiology, physiopathology)
  • Ventricular Dysfunction, Left (etiology, physiopathology)

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