Cardiogenic Shock in Takotsubo Syndrome, a Systematic Review

Abstract

Background: Takotsubo syndrome is a cardiomyopathy induced by physical or emotional stress, characterized by ventricular apical dilatation, knowledge of the pathophysiological mechanisms of the disease is still incomplete. The most widely accepted hypothesis today is that excess catecholamines cause calcium overload in cardiac myocytes, which leads to interruption of contraction and ventricular function. Material and methods: A synthesis of the available evidence about takotsubo syndrome was carried out through a systematic review type study and the maximum number of articles that reported cases of treatment of this entity was included. For this, specific searches were launched with MESH type keywords. Results: 12 articles were selected. This included a total of 351,124 patients with Takotsubo syndrome, with a mean of 70,224 per study, of whom 5.82% (20,418 of 351,124) were complicated by cardiogenic shock. Among the risk factors associated with cardiogenic shock were found: Use of drugs such as cocaine, peaks of emotional stress, physical stress from surgeries, menopause, hypoglycemia, massive blood loss, hypotension and use of drugs such as atropine, adrenaline, dobutamine, ergonovine, nortriptyline. Conclusion: From the analysis of the results obtained, physical and mental stress are risk factors associated with cardiogenic shock in patients with Takotsubo syndrome, this corresponds to the most accepted hypothesis today that justifies this syndrome with the excess in the production of catecholamines, hormones secreted under stress