Introduction: Tako-tsubo cardiomyopathy represents an intermittent left ventricular dysfunction with a ballooning of the left ventricular apical myocardium without significant coronary artery disease. Precise epidemiological data are not yet available.
Methods and results: We retrospectively reviewed 16,989 cases with diagnostic angiographies in our catheter laboratory from January 2001 until December 2004 for intermittent left ventricular apical ballooning. Thirty-two (0.2%) patients were included (50% of all cases presented in 2004, 50% of all cases during the summer months). Twenty-nine (91%) were female, median age was 67.5 years. Fourteen patients (44%) were known to have chronic obstructive pulmonary disease or asthma. Thirteen patients (41%) reported an acute stressful event prior to onset of symptoms. Twenty-five (78%) of the patients presented with clinical signs of an acute coronary syndrome with positive troponin T in 20 (63%) patients. Median left ventricular ejection fraction was 42.5%. Follow-up data of 30 patients (94%) could be obtained; median follow-up time is 6 months. Two patients died during follow-up (malignancy; unknown cause). Echocardiography was performed in 26 (81%) patients; median ejection fraction was 70%.
Conclusion: Tako-tsubo-like cardiomyopathy might be considered a differential diagnosis for acute coronary syndrome especially in elderly women. Chronic pulmonary diseases may be associated with a higher risk. The reason for the increasing number of cases during the last year is not clear; however, the tendency for early angiography in acute coronary syndrome may have contributed. The reason for the accumulation of cases during the summer months is also not yet understood.