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Tako-Tsubo Syndrome |
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Tako-Tsubo syndrome is a dreadful illness (albeit quite rare) that appears under circumstances of exceptional and extreme stress, at times associated with anger. If this is happening to you, you should try to calm yourself down, if at all possible (although most patients recover completely if supported adequately in a hospital !!!). |
Please read one column after the other. Some comments on Tako-Tsubo Syndrome About 80% of cases of Tako-Tsubo Syndrome (TTS) occur in post-menopausal women under some form of extreme, exceptional and prolonged mental stress,... with no good way out, no relief and often feeling deep resentment (such as the loss of a dear one...) (Note: a word of caution... , in a minority of patients (<20%) the stress is physical (such as massive trauma, surgery or severe pain, or other type of stress. In very rare cases, no "cause" can be found). Tako-tsubo Cardiomyopathy or Syndrome is also known as:
"Tako-tsubo" is the japanese name for octopus traps that fishermen still use to catch octopus. In this syndrome, the heart (left ventricle) takes the shape of an octopus trap (tako-tsubo). How about that! NOTE ( très mucho IMPORTANT and before we forget ! A diagnosis of Tako-Tsubo syndrome can only be made after excluding:
And that leads to the good news, Folks! Suggestion: patients should be send to cardiac rehabilitation and if possible to a stress reduction clinic if the syndrome is complicated by continued stress or by a syndrome similar to PTSD (post-traumatic stress syndrome>. What about tako-tsubo syndrome in the animal kingdom? Despite fancy experimental research protocols designed by the meanest animal on the planet (namely: homo "the meanest mammal" sapiens), tako-tsubo syndrome has not been found in any type of animal as far as we know (except a rat model... Ueyama T. Emotional stress-induced Tako-tsubo cardiomyopathy: animal model and molecular mechanismAnn N Y Acad Sci. 2004 Jun;1018:437-44
Rare video clip in a snowy mountain range of an unfortunate stressed, resentful and angry giraffe running after some scrumptious food. Conclusion from this study: Even maximally stressed giraffes don't get tako-tsubo syndrome...... But there is no need for those fancy experiments...... how about studying non-human primates stuck for life in zoos? I would not be surprised that some Tako-Tsubo cases could be found there....... future will tell... But we should not wait and free those poor primates in their appropriate habitat, with human primates protection.
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Shape of the Left Ventricle in Tako-Tsubo Cardiomyopathy Normal left ventricular contraction
Abnormal contraction of left ventricle taking the shape of a "Tako-Tsubo"
Syndrome named by Sato et al. Syndrome seen in Worcester Massachusetts for a long time (followed up prospectively for up to 11 years) but named differently. "Massive T wave inversion mainly in women, with prognosis independent of ECG changes". Multivessel coronary artery spasm is a possibility. Neurogenic cause is quite likely. First patient cohort described in the U.S. ALERT: what some of us expected to see described has just been ...described...
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Attention: instead of the characteristic takotsubo shape that the heart takes, some patients have, instead, focal or even completely diffuse wall motion abnormalities and therefore the "tako-tsubo" morphological change is not seen... Future research will sort out whether those cases should also be grouped into tako-tsubo syndrome. Nevertheless, transient catecholaminergic myocardial stunning could still be the basis for some of those clinical presentations in patients with little or no coronary stenosis
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Note that central nervous system with its sympathetic and parasympathetic systems is trying to continuously regulate many aspect of our lives. But it can be responsible for innumerable conditions. Such as:
Treatment: Tako-tsubo syndrome is only treated with support measures. Unrecognized or untreated Tako-Tsubo Syndrome:
Note that to this date (when you will read this webpage) Tako-Tsubo Syndrome is often missed because:
Root cause of tako-tsubo syndrome: Mental/Physical Stress appears to be the underlying root cause in many cases. Because of this, some have investigated an excessive endogenous norepinephrine release over the heart muscle. This mechanism is now generally accepted by the medical community. Regarding treatment:
as stated above, we really only have standard support measures that we give to other patients with standard heart failure and stress. There are some attempts to give a calcium channel blocker to prevent coronary spasm, but there is no solid literature on that. Besides, patients often have low blood pressure, preventing us from giving a vasodilator such as a calcium channel blocker. Some physicians prescribe betablockers as tolerated (for instance: low dosage initially). But this is not accepted by everyone.
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Take a deep breath and relax (but don't breath to fast ,... or you will become dizzy and panicky...) |
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