Wanessa Julia da Silva et al. Gabriel Sembeneli Pedro Petiti Arbex Bueno Rafaela Claro Rodrigues … Fernanda Meirelles Gil Flavia Lima Costa Faldoni Claudia Helena Cury Domingos
Introduction
Takotsubo syndrome (TTS) is a medical condition characterized by reversible regional dysfunction of the left ventricle (LV) and/or right ventricle. TTS is often triggered by situations of acute physical or emotional stress. It presents characteristics similar to an acute coronary syndrome (ACS) event, but without coronary abnormality evidenced by exams such as angiography. Furthermore, upon admission, patients with TTS also manifest substantially lower left ventricular ejection fraction (LVEF) values, when compared to those with ACS. Nonetheless, even with these lower levels, the chances of cardiovascular damage are lower, and the restoration of LVEF is more satisfactory.
Although the pathophysiology of TTS is complex and, in part, unknown, studies suggest that exacerbated sympathetic activation, confirmed by increased levels of plasma catecholamines, and adrenergic drugs may precipitate the condition. It predominantly occurs in postmenopausal women. However, it can affect younger women and men, and it is estimated that 1% to 3% of all patients and 5% to 6% of female patients who undergo coronary angiography due to suspected ACS have TTS. Reproductive and hormonal factors and stressful emotional events are associated with greater occurrence of TTS in women, whereas the physical factor is the most frequent agent in men, as well as in patients undergoing chemotherapy treatment.
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