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Takotsubo cardiomyopathy in patients undergoing haemodialysis - mini review apropos of a case

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Resumo:Takotsubo cardiomyopathy is an uncommon clinical entity that mimics acute coronary syndrome (ACS) and may be underdiagnosed among haemodialysis (HD) patients. This topic is, therefore, reviewed based on a clinical case of a 68-year-old woman undergoing haemodialysis. Usually, Takotsubo cardiomyopathy presents itself as an acute myocardial infarction. However unlike ACS, neither a coronary obstructive disease is found nor do cardiac biomarkers correlate with the extensive wall motions defects (apical and midventricular kinesis dysfunction along with basal hypermotility). This defect translates into a jarshaped appearance in ventriculography, and therefore its Takotsubo name (octopus trap, in Japanese “tako” means octopus and “tsubo” means jar). So far, data available from animal models and its resemblance with pheochromocytoma-induced cardiomyopathy suggests that an adrenergic surge might be an underlying mechanism. The overlapping clinical features of takotsubo cardiomyopathy and ACS, the high prevalence of cardiovascular risk factors and the already superimposed cardiovascular disease in chronic kidney disease make it difficult to diagnose among these patients
Autores principais:Torres,João Carlos Sousa
Outros Autores:Birne,Rita Lorena; Pereira,Tiago Assis; Sousa,Henrique Silva; Calenga,Antónia; Branco,Patrícia; Gaspar,Maria Augusta; Barata,José Diogo
Assunto:Apical balooning syndrome haemodialysis stress cardiomyopathy sympathetic nervous system takotsubo cardiomyopathy
Ano:2016
País:Portugal
Tipo de documento:artigo
Tipo de acesso:acesso aberto
Instituição associada:Fundação para a Ciência e Tecnologia
Idioma:inglês
Origem:SciELO Portugal
Descrição
Resumo:Takotsubo cardiomyopathy is an uncommon clinical entity that mimics acute coronary syndrome (ACS) and may be underdiagnosed among haemodialysis (HD) patients. This topic is, therefore, reviewed based on a clinical case of a 68-year-old woman undergoing haemodialysis. Usually, Takotsubo cardiomyopathy presents itself as an acute myocardial infarction. However unlike ACS, neither a coronary obstructive disease is found nor do cardiac biomarkers correlate with the extensive wall motions defects (apical and midventricular kinesis dysfunction along with basal hypermotility). This defect translates into a jarshaped appearance in ventriculography, and therefore its Takotsubo name (octopus trap, in Japanese “tako” means octopus and “tsubo” means jar). So far, data available from animal models and its resemblance with pheochromocytoma-induced cardiomyopathy suggests that an adrenergic surge might be an underlying mechanism. The overlapping clinical features of takotsubo cardiomyopathy and ACS, the high prevalence of cardiovascular risk factors and the already superimposed cardiovascular disease in chronic kidney disease make it difficult to diagnose among these patients