Cardiol Res

Cardiology Research, ISSN 1923-2829 print, 1923-2837 online, Open Access

Article copyright, the authors; Journal compilation copyright, Cardiol Res and Elmer Press Inc

Journal website https://www.cardiologyres.org

Original Article

Volume 5, Number 5, October 2014, pages 139-144

Takotsubo Cardiomyopathy: Typical and Atypical Variants, A Two-Year Retrospective Cohort Study

**Table 1.** Imaging Data and Management
Patient	% EF by LV Gram	Regional wall motion abnormality by angiography	Angiographic findings	Management
1	20	Anteroapical, inferoapical	Normal coronaries	ACE, BB, spironolactone, digoxin
2	15 - 20	Anteroapical, inferoapical, anterolateral	Normal coronaries	ASA, ACE, BB, statin
3	45	Mid anterior	Normal coronaries	ASA, ACE, BB
4	35	Circumferential	Normal coronaries	ASA, ACE, BB, statin
5	45	Anteroapical	30% Prox LAD stenosis	ASA, dalteparin, coumadin
6	40 - 45	Midanterior	Anomalous take off of RCA, normal coronaries	ASA, plavix, ACE, BB, statin
7	35	Midanterior, apical, midinferior	Patent LAD stent, patent coronaries	ASA, ACE, BB
8	< 25	Anterior, anteroapical, inferoapical, midinferior	50% RCA 1 lesion, LAD 50% 2 lesions, second diagnol 50% lesion	ASA, BB, statin
9	45	Midanterior, apical, midinferior	Normal coronaries	Plavix, ACE, BB, statin
10	40	Apical	Occluded marginal, otherwise normal	ASA, plavix, ARB, BB, statin
11	45	Midanterior, midinferior	Normal coronaries	BB, ACE

Table 1. Imaging Data and Management

Patient

% EF by LV Gram

Regional wall motion abnormality by angiography

Angiographic findings

Management

Anteroapical, inferoapical

Normal coronaries

ACE, BB, spironolactone, digoxin

15 - 20

Anteroapical, inferoapical, anterolateral

Normal coronaries

ASA, ACE, BB, statin

Mid anterior

Normal coronaries

ASA, ACE, BB

Circumferential

Normal coronaries

ASA, ACE, BB, statin

Anteroapical

30% Prox LAD stenosis

ASA, dalteparin, coumadin

40 - 45

Midanterior

Anomalous take off of RCA, normal coronaries

ASA, plavix, ACE, BB, statin

Midanterior, apical, midinferior

Patent LAD stent, patent coronaries

ASA, ACE, BB

< 25

Anterior, anteroapical, inferoapical, midinferior

50% RCA 1 lesion, LAD 50% 2 lesions, second diagnol 50% lesion

ASA, BB, statin

Midanterior, apical, midinferior

Normal coronaries

Plavix, ACE, BB, statin

Apical

Occluded marginal, otherwise normal

ASA, plavix, ARB, BB, statin

Midanterior, midinferior

Normal coronaries

BB, ACE

**Table 2.** Patient Demographics
Patient	Age	Sex	Time of onset of symptoms	DM	HTN	Smoking	Stressor
1	64	F	AM	N	Y	Y	COPD exacerbation
2	76	F	AM	N	Y	N	PNA
3	53	F	PM	N	N	N	Family issues
4	81	F	PM	N	Y	Y	Strenuous physical activity
5	43	F	PM	N	N	Y	Chemotherapy
6	65	F	PM	N	N	N	Strenuous physical activity
7	54	F	PM	N	N	Y	Unknown, possibly alcohol
8	72	F	NA	Y	Y	N	Unknown, possibly anxiety
9	67	F	PM	N	N	N	Fall from scooter
10	77	F	AM	N	Y	N	Family issues
11	51	F	NA	N	N	N	Strenuous physical activity

Table 2. Patient Demographics

Patient

Age

Sex

Time of onset of symptoms

HTN

Smoking

Stressor

COPD exacerbation

PNA

Family issues

Strenuous physical activity

Chemotherapy

Strenuous physical activity

Unknown, possibly alcohol

Unknown, possibly anxiety

Fall from scooter

Family issues

Strenuous physical activity

**Table 3.** Lab Data
Patient	Peak troponin (ng/mL)	Peak CK (ng/mL)	Peak CKMB%	Admit EKG	Admit QTc on EKG (ms)	Discharge QTc on EKG (ms)
1	1.45	131	9.2	TWI V3-V6, & AvL, non-specific ST changes	478	438
2	10.59	2,562	3.3	STEMI I, aVL, V2-3	400	436
3	2.92	178	6.2	TWI I, aVL, V1	416	443
4	7.37	400	13	TWI V2-V6, I, aVL, non-specific ST changes	415	405
5	0.7	60	14.2	TWI I, II, aVF, V4-6	501	492
6	2.7	17	10.5	Normal	435	444
7	1.76	168	5.8	Prolonged QT	480	534
8	0.33	32	13	Atrial paced, frequent PVC, lateral TWI, questionable anterior STEMI	486	462
9	2.18	107	17.6	NSR with first AVB, low voltage	432	469
10	1.86	512	1.9	Normal, low voltage	428	430
11	1.03	89	8	Normal	443	470

Table 3. Lab Data

Patient

Peak troponin (ng/mL)

Peak CK (ng/mL)

Peak CKMB%

Admit EKG

Admit QTc on EKG (ms)

Discharge QTc on EKG (ms)

1.45

131

9.2

TWI V3-V6, & AvL, non-specific ST changes

478

438

10.59

2,562

3.3

STEMI I, aVL, V2-3

400

436

2.92

178

6.2

TWI I, aVL, V1

416

443

7.37

400

TWI V2-V6, I, aVL, non-specific ST changes

415

405

0.7

14.2

TWI I, II, aVF, V4-6

501

492

2.7

10.5

Normal

435

444

1.76

168

5.8

Prolonged QT

480

534

0.33

Atrial paced, frequent PVC, lateral TWI, questionable anterior STEMI

486

462

2.18

107

17.6

NSR with first AVB, low voltage

432

469

1.86

512

1.9

Normal, low voltage

428

430

1.03

Normal

443

470