Clinical Profile and Long Term Outcomes in Stress Cardiomyopathy

Abstract

Objective: Stress Cardiomyopathy (SC) also known as Tako-Tsubo Syndrome, is a syndrome characterised by transient systolic dysfunction of the apical and/or mid segments of the left ventricle in absence of obstructive coronary artery disease. We assessed the clinical profile and long-term outcomes of consecutive patients presenting to the Launceston General Hospital with SC between 2006 and 2011. Methods: Patients were diagnosed with SC as per the Mayo Diagnostic Criteria. In-hospital course was noted and long term outcomes were assessed by out-patient assessments, telephonic interviews and review of medical records. Results: Forty-four patients, mean age 64.5years (40-88 years) and predominantly female (93%). Majority (84%) had chest pain and 59% had history of preceding stressful event. ECG showed ST elevation in 25%, T wave changes in 64%, and normal/non-specific ECG in 11% patients. Mean peak troponin I was 4.46 μg/l (0.07–40.3). Follow-up was available for 43/44 (98%) patients with an average of 1.5 years (12 days to 4.7 years). There were five deaths (one sudden death, one multi-system organ failure, three non-cardiac). One patient had an ischaemic stroke at 11 days, six patients had recurrent chest pain, and two had re-infarction. Follow-up echocardiograms were performed in 84% and demonstrated normalisation of systolic function in all but four patients. Conclusions: Our long term study demonstrates that despite recovery of LV function in the majority of Stress Cardiomyopathy, it is not entirely benign and is associated with significant cardiac morbidity.