Introduction

Takotsubo cardiomyopathy is a type of non-ischaemic cardiomyopathy associated with a transient, apical ballooning of the myocardium. It may be triggered by stress.

Epidemiology

  • Incidence: 3.00 cases per 100,000 person-years
  • Peak incidence: 60-70 years
  • Sex ratio: more common in females 8:1
Condition Relative
incidence
Myocarditis6.67
Takotsubo cardiomyopathy1
<1 1-5 6+ 16+ 30+ 40+ 50+ 60+ 70+ 80+

Pathophysiology

Pathophysiology
  • Takotsubo is a Japanese word that describes an octopus trap
  • the apical ballooning appearance occurs due to severe hypokinesis of the mid and apical segments with preservation of activity of the basal segments. In simple terms, the bottom of the heart (the apex) does not contract and therefore appears to balloon out. However, the area closer to the top (the base) continues to contract (creating the neck of the octopus trap)

Clinical features

Features
  • chest pain
  • features of heart failure
  • ST elevation
  • normal coronary angiogram

Management

Treatment is supportive.