Comparison of Clinical Features between Typical and Atypical Takotsubo Cardiomyopathy: A Single Center, Retrospective, Case-Controlled Study.

Background: The incidence and possible differences between typical and atypical Takotsubo cardiomyopathy (TTC) in Taiwanese patients have not yet been assessed.

Methods: We reviewed the records of 2171 patients who underwent left heart catheterization for suspected acute coronary syndrome (ACS) between January 2003 and March 2011 to identify TTC. Demographic, clinical presentations, laboratory data, and electrocardiographic, echocardiographic and angiographic findings were assessed in all patients.

Results: We found that fourteen patients had typical TTC, and six had atypical TTC. There were no differences in the clinical presentations, ejection fraction and in-hospital course of illness between patients with typical TTC (the TT group) and patients with atypical TTC (the AT group). However, the patients in the AT group were relatively younger than those in the TT group (mean ages 60 vs. 73 years, respectively, p = 0.018), and fewer patients had hypertension in the AT group than in the TT group (33% vs. 86%, respectively, p = 0.037). In electrocardiography, ST segment elevation was noted less frequently in the AT group than in the TT group (33% vs. 86%, respectively, p = 0.037).

Conclusions: Atypical TTC and typical TTC may be the same syndrome with different manifestations. They seemed to have different patient characteristics and electrocardiographic changes.

Key Words: Acute coronary syndrome; Takotsubo cardiomyopathy; Transient left ventricular apical ballooning.