Clinical Characteristics and Presentations of Takotsubo in Queensland

Abstract

Takotsubo cardiomyopathy is an increasingly recognised cause of acute coronary syndrome. Recent studies in the New England Journal of Medicine have sought to characterise these patients. Our institution noticed a higher incidence than that reported in the literature. We performed this study to determine the local characteristics, presentation, and management of our patients with Takotsubo cardiomyopathy. We searched our QCORE angiography database between 2014 and 2018 for the keyword ‘Takotsubo’. The baseline characteristics and presenting history were then reviewed on the electronic medical record and correlated with the angiographic and echocardiographic findings. A total of 104 cases were identified during this period. Seventy-eight per cent were female, with a median age of 67 years. Sixty-seven per cent presented with chest pain, 30% had predominant dyspnoea, and the median troponin I was 0.92. The average ejection function was 46%. Thirty-nine per cent had a history of anxiety/depression with 33% on treatment for this. Only 15% had a history of angina and 20% had diabetes, but 49% were smokers. Four per cent of patients died within 12 months. In terms of management 57% received aspirin with only 9% discharged on dual antiplatelet therapy. Seventy-five per cent and 78% were discharged on beta blockers and angiotensin-converting enzyme inhibitors, respectively. These clinical characteristics appear consistent with that reported in the New England Journal of Medicine article referenced above. Our management appears to be in keeping with the current guidelines. To our knowledge, this is the largest series of Takotsubo cardiomyopathy reported in Australia.