Abstract
Takotsubo syndrome is a type of acute reversible heart failure that can involve a form of acute catecholaminergic myocardial stunning. This clinical entity shows a pattern of temporary left ventricular dysfunction in the absence of occlusion of any coronary artery. A midventricular type is a form of Takotsubo syndrome where the atypical morphological variant is Hawk’s beak. The prevalence of this type is estimated to be 10-15% in several series in Asian and Western countries (predominantly Caucasian patients). In Latin America, there are no studies reporting this type of presentation. Two cases are reported in women initially diagnosed with acute myocardial infarction with the finding of the atypical hawk's beak morphology of Takotsubo syndrome, confirmed by left ventriculography. One of them was followed up early, observing recovery in her ventricular function without structural compromise at the level of contractility and with a good response to the outpatient treatment proposed. As there is a low prevalence and few published reports, these 2 cases are presented to promote long-term studies and increase the information regarding the evolution and morbidity/mortality of this type of presentation compared with the classical form of the syndrome.
Highlights
IntroductionIt is known that the most vulnerable patients in terms of adherence to treatment are those with few or asymptomatic chronic diseases or if there is no proper monitoring of the indicators of the effectiveness of the therapy
The aim of this work was to assess the main characteristics of patients with non-valvular Atrial Fibrillation (AF) who were initially nonadherent to New Oral Anticoagulants (NOAC) to identify the factors associated with this version of non-adherence
After 1 year of observation, 18 out of 33 patients started taking NOAC, and 15 (7.5%) patients remained in the primary non-adherence category
Summary
It is known that the most vulnerable patients in terms of adherence to treatment are those with few or asymptomatic chronic diseases or if there is no proper monitoring of the indicators of the effectiveness of the therapy. These criteria fully correspond to those patients with non-valvular Atrial Fibrillation (AF) receiving therapy with New Oral Anticoagulants (NOAC). Refusal to take these drugs leads to a high risk of thromboembolic complications. Determination of the main characteristics of patients with non-valvular AF who refuse to start taking NOAC and identifying factors that prevent the initiation of NOAC treatment is an important and urgent task
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