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Miocardiopatia de Takotsubo

O Estado da Arte
Authors: Pereira, Sofia Micaela Reinolds;

Miocardiopatia de Takotsubo

Abstract

Nos últimos 25 anos, a Síndrome de Takotsubo emergiu como uma apresentação relevante de lesão miocárdica aguda, caracterizada por uma falha distinta regional na contracção ventricular, normalmente acompanhada por uma significativa redução na fracção de ejecção ventricular esquerda, sendo tipicamente reversível. Identificada primariamente por cientistas Japoneses em 1991, esta patologia foi designada Takotsubo devido à sua apresentação característica no ecocardiograma, semelhante ao vaso usado para pescar polvos. Takotsubo é uma síndrome que mimetiza o enfarte agudo do miocárdio, na ausência de doença arterial obstrutiva coronária epicárdica, de forma a explicar o grau de anormalidade na motilidade da parede ventricular. Usualmente, mais comum nas mulheres idosas, esta condição é, geralmente, desencadeada por situações inesperadas de stress emocional ou físico, estando associada a alterações no eletrocardiograma e ligeira elevação nos biomarcadores cardíacos. O mecanismo fisiopatológico ainda não está claro, mas acredita-se que uma alta concentração circulante de catecolaminas provoca uma disfunção aguda da microcirculação coronária e do metabolismo dos cardiomiócitos, levando a um atordoamento transitório do miocárdio. As recorrências são raras e julga-se que o prognóstico a longo prazo é bom. O tratamento durante a fase aguda é principalmente sintomático. Não há consenso quanto à terapêutica a longo prazo para a Síndrome de Takotsubo.

In the last 25 years, the Takotsubo Syndrome has emerged as an important form of acute myocardial injury characterized by distinctive regional left ventricular contraction failure, often with marked reduction of left Ventricular ejection fraction, and is typically completely reversible. First identified by Japanese scientists in 1991, this disorder was named for the distinctive echocardiogram’s resemblance to traditional takotsubo, or octopus fishing pots. Takotsubo is a syndrome that mimics an acute myocardial infarction in absence of obstructive epicardial coronary artery disease to explain the degree of the wall motion abnormalities. Typically more common in the elderly women, this condition is usually triggered by unexpected emotional or physical stress situations, and is associated with electrocardiogram abnormalities and slight elevation of cardiac biomarkers. The pathophysiological mechanism is not clear yet, but it is believed that a high circulating concentration of catecholamines causes an acute dysfunction of the coronary microcirculation and metabolism of cardiomyocytes, leading to a transient myocardial stunning. Recurrences are rare and it is thought that the long-term prognosis is good. Treatment during the acute phase is mainly symptomatic treatment. There is no consensus regarding long-term management of Takotsubo Syndrome.

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Portugal
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Keywords

Síndrome de Takotsubo, Cardiomiopatia de Stress, Balão Apical, Domínio/Área Científica::Ciências Médicas::Ciências da Saúde::Medicina, Sistema Nervoso Simpático

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popularity
This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.
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influence
This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
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impulse
This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
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