Hopp til hovedinnhold

Stress kardiomyopati

Sist oppdatert: Sist revidert:
Sist revidert av:
Definisjon:
Akutt hjertesvikt i ellers friskt hjerte, oftest utløst av fysisk eller emosjonelt stress
Forekomst:
Utgjør ca. 1% av alle pasienter som innlegges med akutt koronarsyndrom. Ni av ti er kvinner.
Symptomer:
Akutt innsettende brystsmerter og tung pust
Funn:
Blek og medtatt pasient med rask respirasjon, takykardi og takypne
Diagnostikk:
I sykehus tas EKG, troponin, koronar angiografi og diagnosen bekreftes ved ekko-u.s.
Behandling:
Behandlingen er intensiv hjertesviktbehandling inntil normalisering av pumpefunksjon
  1. Eitel I, Behrendt F, Schindler K, et al. Differential diagnosis of suspected apical ballooning syndrome using contrast-inhanced magentic resonance imaging. Eur Heart J 2008; 29: 2651-9. European Heart Journal  
  2. Hurst RT, Prasad A, Askew JW, et al. Takutsubo kardiomyopathi: a unique cardiomyopathi with variable ventricular morphology. JACC Cardiovasc Imaging 2010; 3: 641-9. PubMed  
  3. Gianni M, Dentali F, Grandi AM, et al. Apical ballooning syndrome or takotsubo cardiomyopathy: a systematic review. Eur Heart J 2006; 27: 1523. European Heart Journal  
  4. Prasad A, Dangas G, Srinivasan M, et al. Incidence and angiographic characteristics of patients with apical ballooning syndrome (takotsubo/stress cardiomyopathy) in the HORIZONS-AMI trial: an analysis from a multicenter, international study of ST-elevation myocardial infarction. Catheter Cardiovasc Interv 2014; 83: 343. pmid:22121008 PubMed  
  5. Akashi YJ, Goldstein DS, Barbaro G, Ueyama T. Takotsubo cardiomyopathy: a new form of acute, reversible heart failure. Circulation 2008; 118: 2754. Circulation  
  6. Templin C, Ghadri JR, Diekmann J, et al. Clinical features and outcomes of takotsubo (stress) cardiomyopathi. N Engl J Med 2015; 373: 929-38. PMID: 26332547 PubMed  
  7. Ghadri JR, Kato K, Cammann VL, et al. Long-term prognosis of patients with Takotsubo syndrome. J Am Coll Cardiol 2018; 72: 874-82. PMID: 30115226 PubMed  
  8. Sharkey SW, Maron BJ. Survival after Takotsubo, revisited. J Am Coll Cardiol 2018 Aug 21; 72:883-4. PMID: 30115227 PubMed  
  9. Neil CJ, Chong CR, Nguyen TH, et al. Occurrence of Tako-Tsubo cardiomyopathy in association with ingestion of serotonin/noradrenaline reuptake inhibitors. Heart Lung Circ 2012; doi.org/10.1016/j.hlc.2011.12.004.
  10. Goodloe AH, Evans JM, Middha S, Prasad A, Olson TM . Characterizing genetic variation of adrenergic signalling pathways in Takotsubo (stress) cardiomyopathy exomes. Eur J Heart Fail 2014; 16: 942-9. pmid:25132214 PubMed  
  11. Scantlebury DC, Rohe DE, Best PJM, et al. Stress-coping skills and neuroticism in apical ballooning syndrome (Takotsubo/stress cardiomyopathi). Open Heart 2016. doi:10.1136/openhrt-2015-000312 DOI  
  12. Eitel I, von Knobelsdorff-Brenkenhoff F, Bernhardt P, et al. Clinical characteristics and cardiovascular magnetic resonance findings in stress (takotsubo) cardiomyopathy. JAMA 2011; 306: 277-86. Journal of the American Medical Association  
  13. Prasad A, Lerman A, Rihal CS. Apical ballooning syndrome (takutsubo or stress cardiomyopathi): a mimic of acute myocardial infarction. Am Heart J 2008; 155: 408-17. PubMed  
  14. Sharkey SW, Lesser JR, Zenovich AG, et al. Acute and reversible cardiomyopathy provoked by stress in women from the United States. Circulation 2005; 111: 472. Circulation  
  15. Daeson DK. Acute stress-induced (takotsubo) cardiomyopathy. Review. Heart 2017. doi:10.1136/heartjnl-2017-311579 DOI  
  16. Sharkey SW, Windenburg DC, Lesser JR. Natural history and expansive clinical profile of stress (tako-tsubo) cardiomyopathy. J Am Coll Cardiol 2010; 55: 333. PubMed  
  17. Haghi D, Athanasiadis A, Papavassiliu T, et al. Right ventricular involvement in Takotsubo cardiomyopathy. Eur Heart J 2006; 27: 2433. European Heart Journal  
  18. Isogai T, Matsui H, Tanaka H, et al. Early β-blocker use and in-hospital mortality in patients with Takotsubo cardiomyopathy. Heart 2016. doi:10.1136/heartjnl-2015-308712 DOI  
  19. Silverio A, Parodi G, Scudiero F, et al. Beta-blockers are associated with better long-term survival in patients with Takotsubo syndrome. Heart 2022. pmid:35361673 PubMed  
  20. Santoro F, Sharkey C, Citro R, et al. Beta-blockers and renin-angiotensin system inhibitors for Takotsubo syndrome recurrence: a network meta-analysis. Heart 2023. pmid:37666647 PubMed  
  21. Nef HM, Möllmann H, Kostin S, et al. Tako-Tsubo cardiomyopathy: intraindividual structural analysis in the acute phase and after functional recovery. Eur Heart J 2007; 28: 2456. European Heart Journal  
  22. Looi J-L, Lee M, Webster MWI, et al. Postdischarge outcome after Takotsubo syndrome compared with patients post-ACS and those without prior CVD: ANZACS-QI 19. Openheart 2018. doi:10.1136/openhrt-2018-000918 DOI  
  23. Elesber AA, Prasad A, Lennon RJ, et al. Four-year recurrence rate and prognosis of the apical ballooning syndrome. J Am Coll Cardiol 2007; 50: 448. PubMed  
  • Ingard Løge, spesialist allmennmedisin, redaktør Norsk Elektronisk Legehåndbok

Tidligere fagmedarbeidere

  • Bjørnar Grenne, PhD, konst. overlege, Klinikk for hjertemedisin, St. Olavs Hospital, Trondheim