Abstract 318: Takotsubos Cardiomyopathy-EKG presentations

Background: In patients presenting with a clinical picture of acute myocardial infarction (MI), Stress induced or Takotsubos cardiomyopathy (TCM), once considered rare is now an increasingly considered differential diagnosis. Literature regarding this disease is relatively scarce. We aimed to review the electrocardiogram (EKG ) presentation of these patients. Methods: Medical records were reviewed for patients, from 2006 onwards, with either a discharge diagnosis of TCM or with a clinical presentation of acute MI and with ventriculogram on cardiac catheterizations (CC) but without any coronary interventions. We retrieved 972 patients and of those 99 met the criteria for TCM after a detailed review of their records Results: ST elevations were seen on EKG in 20% of patients-15 patients were initially considered a STEMI and another 5 were considered a possible STEMI .80% presented as unstable angina or a NTEMI with elevated troponins and of these 50% showed t wave changes suggestive of ischemia on EKG. Of the STEMI, 6 showed ST elevations in the anterior or anteroseptal leads, 7 showed ST elevations in the lateral or anterolateral leads, 4 showed ST elevations in the inferior leads and 3 showed diffuse ST segment elevations. Only one patient showed the classic reciprocal ST segment depression on EKG. However, the type of EKG presentations did not affect in hospital mortality or recovery of LV function Conclusions: Most TCM patients who present like a STEMI have ST segment elevations without the classical ST reciprocal depressions. They also present with higher Troponin and CKMB values, similar to STEMI due to obstructive CAD, than patients who present like a NSTEMI. However this did not appear to influence in hospital mortality or recovery of LV function.