Incidence and clinical characteristics of takotsubo cardiomyopathy post-aneurysmal subarachnoid hemorrhage

Abstract

Takotsubo cardiomyopathy (TCMP), also known as stress-induced cardiomyopathy, broken heart syndrome or apical ballooning syndrome, is an increasingly recognized syndrome characterized by reversible left ventricular (LV) dysfunction, electrocardiographic (ECG) changes and release of myocardial enzymes that mimic myocardial infarction in the absence of obstructive coronary artery disease (CAD) [ [1] Tsuchihashi K. Ueshima K. Uchida T. et al. Transient left ventricular apical ballooning without coronary artery stenosis: a novel heart syndrome mimicking acute myocardial infarction. J Am Coll Cardiol. 2001; 38: 11-18 Abstract Full Text Full Text PDF PubMed Scopus (1333) Google Scholar ], attributed to a surge in catecholamine levels precipitated by an acute physical or emotional stressor [ 2 Pilgrim T.M. Wyss T.R. Takotsubo cardiomyopathy or transient left ventricular apical ballooning syndrome: a systematic review. Int J Cardiol. 2008; 124: 283-292 Abstract Full Text Full Text PDF PubMed Scopus (387) Google Scholar , 3 Wittstein I.S. Thiemann D.R. Lima J.A.C. et al. Neurohumoral features of myocardial stunning due to sudden emotional stress. N Engl J Med. 2005; 352: 539 Crossref PubMed Scopus (2324) Google Scholar ]. Stress-induced cardiomyopathy following subarachnoid hemorrhage (SAH) has been described primarily in case reports and small case series [ 2 Pilgrim T.M. Wyss T.R. Takotsubo cardiomyopathy or transient left ventricular apical ballooning syndrome: a systematic review. Int J Cardiol. 2008; 124: 283-292 Abstract Full Text Full Text PDF PubMed Scopus (387) Google Scholar , 4 Caretta G. Vizzardi E. Rovetta R. et al. The link between intracranial haemorrhage and cardiogenic shock: a case of takotsubo cardiomyopathy. Acta Cardiol. 2012 Jun; 67: 363-365 PubMed Google Scholar ], but data from larger series are lacking. The aim of this study was to report the incidence and describe the clinical characteristics of patients with non-traumatic SAH and evidence of TCMP.