• the Tako-tsubo syndrome is characterized by acute chest pain accompanied by reversible apical ballooning in the absence of significant coronary artery disease
  • features include transient left ventricular (LV) dysfunction, electrocardiographic changes, and minimal myocardial enzymatic release mimicking acute myocardial infarction (MI) (1)
• early left ventriculography revealed basal normokinesia and apical akinesia at the same time, and the end-systolic ventriculogram looked like a "tako-tsubo" used for trapping octopuses in Japan - thus the term "tako-tsubo-like LV dysfunction" was proposed in 1990 for this condition
• the Tako-Tsubo syndrome has been widely recognized in Japan and a multicenter study (2) showed some of the clinical features, including a predominance of elderly women, as well as a favorable prognosis
  • angiographic main findings were:

  1) LV asynergy extended over more than one coronary artery region and was quite different from that in acute MI;

  2) this asynergy was localized to the apical region; and

  3) this asynergy was dramatically resolved in a short time.

• an episode of emotional or physiologic stress frequently precedes presentation with the syndrome (3)

Note that little is known about its pathophysiology, partly because the condition was rare.

Reference:

1. S. Kurisu, H. Sato, T. Kawagoe et al., Tako-tsubo-like left ventricular dysfunction with ST segment elevation: a novel cardiac syndrome mimicking acute myocardial infarction. Am Heart J 2002;143:448–455
2. K. Tsuchihashi, K. Ueshima, T. Uchida 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
3. Ann Intern Med. 2004;141(11):858-65