P78 PSYCHIATRIC PATHOLOGIES PREVALENCE OF IN TAKOTSUBO SYNDROME

Abstract

Abstract Background Tako Tsubo syndrome (TTS) is characterized by transient alterations of ventricular kinetics (ATC) in the absence of obstructive epicardial coronary artery disease. Materials 39 cases of TTS that came to our observation from 2005 to 2019 are described, the diagnosis was made on the basis of evidence of ATC, ECG alterations, increase necrosis markers in the absence of obstructive coronary disease, excluding myocarditis. Results 39 patients (PZ) (35 females and 4 males) diagnosed with TTS had an average age of 61 ± 13.21 years and symptoms at onset were mainly angina in 28 PZs (72%), dyspnea was present in 8 (20%) and syncope in 3 (8%). ECG changes were characterized by ST depression and/or negative T waves in 30 patients (77%), in 9 (23%) the ST segment was elevated. ATV involved apical segments (SAP) in 27 PZ (69%), 4 (10%) the basal segments (SBA), 2 (5%) the middle segments (SME) and 6 (15%) had focal points abnormalities (FOC). The average Ejection Fraction (FE) on admission was 36.85%, in PZ with ATV of SAP 33.96%, when involved SBA 41%, SME 43.5% and FOC 44.83%. Haemodynamic conditions were stable in 33 pts (84%), 3 pts (8%) presented cardiogenic shock, 3 (8%) pulmonary edema. Arrhythmias were present in 1/3 of the cases. Atrial fibrillation in 38%, extrasystolic arrhythmia in 30%, one patient with sustained ventricular tachycardia, and three patients with total BAV (23%) of which one in shock. In 10% of cases (4 PZ) there was a subvalvular aortic gradient at discharge disappeared. In 8% (3 PZ) was a recurrent TTS. 92% of the PZ reported a psychophysical stress in the 24 hours preceding the event, and a psychiatric pathology was present in 90%. However, only in 60% of cases the psychiatric diagnosis was known on admission, in the remaining 40% the diagnosis was made subsequently, and among the PZ being treated only in ¼ of the cases was it judged adequate. Conclusions In our series, SAP involvement was associated with lower EF values and greater hemodynamic compromise. Involvement of SME, SBA or FOC was associated with higher EF values and less hemodynamic compromise. A psychiatric pathology was present in over 90% of the PZ even if in 40% of the cases it was not ascertained at the time of admission, and in 75% of the PZ in which the diagnosis was known, the treatment was not adequate.