Endocrine disorders may trigger cardiovascular risk factors. Takotsubo cardiomiopathy (TTC) represents an uncommon clinical condition characterized by a clinical picture similar to that of acute myocardial infarction , but with no angiographical evidence of coronary vascular damage. It involves 1.7-2.2% of patients with suspected acute coronary syndrome, and is considered a typical post-menopausal disease following intense emotional stress. The aim of this study was to investigate the association between endocrine disorders and TTC, as documented by case reports. We systematically explored PubMed and Embase medical information source, with the following keywords: takotsubo cardiomyopathy, stress-induced cardiomyopathy, apical ballooning syndrome, endocrinopathy, thyroid, pituitary, and adrenal gland disease, and poliendrocrine syndrome. Author, year of publication, patients' sex, age, triggers, therapy of acute events, and outcomes, were recorded. We identified 53 case reports, mainly women (n=42, 79.2%), mean age 58.6±19.8 years. TTC was more likely in the presence of thyroid (43.4%) or pituitary dysfunctions (24.5%), and less likely in association with adrenal, pancreatic and polyendocrine diseases. Several hormonal dysfunctions, not strictly limited to catecholamines, may play important role in increasing susceptibility of patients, mainly womern, to TTC in stress conditions. Patients presenting with suspected TTC are mostly evaluated by emergency department physicians, often staffing specific chest pain units [83]. Thus, it seems reasonable that they are sufficiently trained also in the diagnosis and treatment of endocrine diseases, since therapeutical approach is based on supportive therapy associated with specific hormonal deficiency treatment.
Takotsubo cardiomyopathy and endocrine disorders: a mini-review of case reports.
DE GIORGI, Alfredo;FABBIAN, Fabio;TISEO, Ruana;MANFREDINI, Roberto
2014
Abstract
Endocrine disorders may trigger cardiovascular risk factors. Takotsubo cardiomiopathy (TTC) represents an uncommon clinical condition characterized by a clinical picture similar to that of acute myocardial infarction , but with no angiographical evidence of coronary vascular damage. It involves 1.7-2.2% of patients with suspected acute coronary syndrome, and is considered a typical post-menopausal disease following intense emotional stress. The aim of this study was to investigate the association between endocrine disorders and TTC, as documented by case reports. We systematically explored PubMed and Embase medical information source, with the following keywords: takotsubo cardiomyopathy, stress-induced cardiomyopathy, apical ballooning syndrome, endocrinopathy, thyroid, pituitary, and adrenal gland disease, and poliendrocrine syndrome. Author, year of publication, patients' sex, age, triggers, therapy of acute events, and outcomes, were recorded. We identified 53 case reports, mainly women (n=42, 79.2%), mean age 58.6±19.8 years. TTC was more likely in the presence of thyroid (43.4%) or pituitary dysfunctions (24.5%), and less likely in association with adrenal, pancreatic and polyendocrine diseases. Several hormonal dysfunctions, not strictly limited to catecholamines, may play important role in increasing susceptibility of patients, mainly womern, to TTC in stress conditions. Patients presenting with suspected TTC are mostly evaluated by emergency department physicians, often staffing specific chest pain units [83]. Thus, it seems reasonable that they are sufficiently trained also in the diagnosis and treatment of endocrine diseases, since therapeutical approach is based on supportive therapy associated with specific hormonal deficiency treatment.I documenti in SFERA sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
