Midventricular takotsubo syndrome: different dyskinesia location leading to a different electrocardiogram?
| Autor: | Alessandro Sionis, J Carreras Mora, M Vidal Burdeus, J Sans Rosello, P Del Castillo, A Duran Cambra, J Sanchez Vega, M Padilla Lopez, L Rodriguez Sotelo, M Vila Perales |
|---|---|
| Rok vydání: | 2021 |
| Předmět: |
medicine.medical_specialty
Takotsubo syndrome business.industry 12 lead ecg Left ventriculography General Medicine Critical Care and Intensive Care Medicine QT interval Dyskinesia Internal medicine T wave Cardiology medicine ST segment Symptom onset medicine.symptom Cardiology and Cardiovascular Medicine business |
| Zdroj: | European Heart Journal. Acute Cardiovascular Care. 10 |
| ISSN: | 2048-8734 2048-8726 |
| DOI: | 10.1093/ehjacc/zuab020.123 |
| Popis: | Funding Acknowledgements Type of funding sources: None. Background Takotsubo syndrome (TKS) is characterized by the appearance of apical reversible dyskinesia in its typical form. Electrocardiogram (ECG) in the acute phase ( Purpose To compare ECG in the acute phase of typical TKS versus mid-ventricular TKS, as it was the more frequent form of atypical TKS in our registry. Methods Patients included in the prospective TKS registry of our center according to the Mayo Clinic diagnostic criteria, with the first ECG performed less than 12 hours from the symptoms onset were reviewed. All cardiac left ventriculographies were reviewed to ensure a correct classification of the different types of TKS. Results A total of 297 patients were included in our local registry. 80 patients met our study inclusion criteria. 56 ECGs of typical apical TKS were compared to 24 ECGs of atypical midventricular TKS. There were no differences between the baseline characteristics in both groups, except for mid-ventricular TKS, that was more frequently triggered by physical stressor. Regarding the ECG analysis, the main difference found in our serie was related to ST-segment deviation (Table 1). While ST-segment elevation was more common in typical TKS than in atypical TKS (73% vs 50%), ST-segment depression (generally in inferior leads) was observed in 54% of patients with atypical TKS and in no patient with typical TKS (figure 1). Conclusion The different location of dyskinesia between typical TKS and mid-ventricular TKS is associated to significant differences in the ECG obtained in the first hours after the onset of the clinical symptoms. The presence of ST-segment depression is highly suggestive of mid-ventricular TKS. ECG characteristicsTypical (n = 56)Midventricular (n = 24)pSTe > 1mm, no (%)41 (73)12 (50)0,044STd >0,5 mm, no (%)013 (54)< 0,001T wave inversion, no (%)12 (21)4 (17)0,626Q wave, no (%)22 ( 39)12 (50)0,374cQT, mean (SD)445 (54)438 (37)0,578QRS low voltages*, n (%)9 ( 16)1 (4)0,328STe ST-segment elevation, STd: ST-segment depression, cQT: corrected QT interval *Voltages |
| Databáze: | OpenAIRE |
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