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• W2166732010 abstract "The case report by Rodriguez et al.,1Rodriguez F. Nathan A.S. Navathe A.S. Ghosh N. Shah P.B. Serial classic and inverted pattern takotsubo cardiomyopathy in a middle-aged woman.Can J Cardiol. 2014; 30: 1462.e7-1462.e9Abstract Full Text Full Text PDF Scopus (6) Google Scholar published ahead of print in the Canadian Journal of Cardiology on April 5, 2014, about the 56-year-old woman who has suffered 3 consecutive episodes of Takotsubo syndrome (TTS) involving different myocardial territories, although not unique, is of interest because it highlights the issue of recurrence of the disease, which probably is more frequent than currently believed, perhaps in mild or atypical forms.2Madias J.E. Forme fruste cases of Takotsubo syndrome: a hypothesis.Eur J Intern Med. 2014; 25: e47Abstract Full Text Full Text PDF PubMed Scopus (51) Google Scholar I will very much appreciate the response of the authors on the following:1.Was this woman troubled with chronic episodes of similar symptoms, but of milder degree, than the ones associated with her 3 documented episodes of TTS?2.In reference to the authors' comment that TTS, “presents with anteroapical akinesis and compensatory hypercontractility of the basal segments,” one can also view the basal segment's contractile pattern as a “part and parcel” component of the TTS classic phenotype and not as “compensatory” in its mechanism.3.Although the authors present data from echocardiograms, cardiac catheterization, and magnetic resonance images, they provide merely a description of the patient's electrocardiograms (ECGs); ECGs have been reported to be different in the classic, inverted, and TTS forms involving the midventricular myocardial region,3Madias J.E. Electrocardiogram lead-specific QRS attenuation in an atypical midventricular case of Takotsubo syndrome.J Electrocardiol. 2013; 46: 728-729Abstract Full Text Full Text PDF PubMed Scopus (17) Google Scholar and thus providing information on the serial ECGs for each of the 3 episodes of TTS in this patient—particularly regarding development of T-wave inversions, QTc interval prolongation, and transient attenuation of the amplitude of the QRS complexes—may be useful.3Madias J.E. Electrocardiogram lead-specific QRS attenuation in an atypical midventricular case of Takotsubo syndrome.J Electrocardiol. 2013; 46: 728-729Abstract Full Text Full Text PDF PubMed Scopus (17) Google Scholar, 4Madias J.E. Transient attenuation of the amplitude of the QRS complexes in the diagnosis of Takotsubo syndrome.Eur Heart J Acute Cardiovasc Care. 2014; 3: 28-36Crossref PubMed Scopus (135) Google ScholarDisclosuresThe author has no conflicts of interest to disclose. The case report by Rodriguez et al.,1Rodriguez F. Nathan A.S. Navathe A.S. Ghosh N. Shah P.B. Serial classic and inverted pattern takotsubo cardiomyopathy in a middle-aged woman.Can J Cardiol. 2014; 30: 1462.e7-1462.e9Abstract Full Text Full Text PDF Scopus (6) Google Scholar published ahead of print in the Canadian Journal of Cardiology on April 5, 2014, about the 56-year-old woman who has suffered 3 consecutive episodes of Takotsubo syndrome (TTS) involving different myocardial territories, although not unique, is of interest because it highlights the issue of recurrence of the disease, which probably is more frequent than currently believed, perhaps in mild or atypical forms.2Madias J.E. Forme fruste cases of Takotsubo syndrome: a hypothesis.Eur J Intern Med. 2014; 25: e47Abstract Full Text Full Text PDF PubMed Scopus (51) Google Scholar I will very much appreciate the response of the authors on the following:1.Was this woman troubled with chronic episodes of similar symptoms, but of milder degree, than the ones associated with her 3 documented episodes of TTS?2.In reference to the authors' comment that TTS, “presents with anteroapical akinesis and compensatory hypercontractility of the basal segments,” one can also view the basal segment's contractile pattern as a “part and parcel” component of the TTS classic phenotype and not as “compensatory” in its mechanism.3.Although the authors present data from echocardiograms, cardiac catheterization, and magnetic resonance images, they provide merely a description of the patient's electrocardiograms (ECGs); ECGs have been reported to be different in the classic, inverted, and TTS forms involving the midventricular myocardial region,3Madias J.E. Electrocardiogram lead-specific QRS attenuation in an atypical midventricular case of Takotsubo syndrome.J Electrocardiol. 2013; 46: 728-729Abstract Full Text Full Text PDF PubMed Scopus (17) Google Scholar and thus providing information on the serial ECGs for each of the 3 episodes of TTS in this patient—particularly regarding development of T-wave inversions, QTc interval prolongation, and transient attenuation of the amplitude of the QRS complexes—may be useful.3Madias J.E. Electrocardiogram lead-specific QRS attenuation in an atypical midventricular case of Takotsubo syndrome.J Electrocardiol. 2013; 46: 728-729Abstract Full Text Full Text PDF PubMed Scopus (17) Google Scholar, 4Madias J.E. Transient attenuation of the amplitude of the QRS complexes in the diagnosis of Takotsubo syndrome.Eur Heart J Acute Cardiovasc Care. 2014; 3: 28-36Crossref PubMed Scopus (135) Google Scholar DisclosuresThe author has no conflicts of interest to disclose. The author has no conflicts of interest to disclose. Serial Classic and Inverted Pattern Takotsubo Cardiomyopathy in a Middle-Aged WomanCanadian Journal of CardiologyVol. 30Issue 11PreviewWe report the case of a 56-year-old woman with no significant medical history who was diagnosed with recurrent Takotsubo cardiomyopathy with variations in ventricular regional involvement including the classic and inverted patterns. She presented on 3 separate occasions with these findings; emotional stressors provoked all presentations. We present echocardiography, cardiac catheterization, and magnetic resonance images from her consecutive presentations. This case of emotional stress repeatedly eliciting classic and inverted forms of Takotsubo cardiomyopathy within the same patient highlights the importance of elucidating the pathological mechanisms of regional ventricular dysfunction. Full-Text PDF" @default.
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• W2166732010 title "Serial Takotsubo Syndrome and Its Implications" @default.
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