Jeder kennt gebrochene Herzen, kaum einer die dazugehörige Kardiomyopathie. Jeder
weiß, dass zu viel Stress langfristig schädlich ist; kaum einer weiß, dass zu viel
Stress auch plötzlich tödlich sein kann. Takotsubo ist die Form, die beschreibt wie
es aussieht, wenn Stress das Herz bricht.
Abstract
Takotsubo cardiomyopathy is usually triggered by emotional or physical stress. Postmenopausal
women are affected in about 90% of cases. Little is known about the underlying pathophysiology,
but excess of stress hormones is crucial. There is a sudden onset of left-ventricular
dilatation and dysfunction. Patients develop angina, dyspnea, fatigue and occasionally
syncopes. They present with acute heart failure, in extensive cases signs of cardiogenic
shock. One can observe abnormal repolarization on ECG, elevated markers of myocardial
necrosis and a typical pattern of impaired systolic contraction on cardiac imaging
(echo, levocardiography, MRI). Obstructive coronary artery disease is the main differential
diagnosis and needs to be out ruled (coronary angiography, CT angiography). Treatment
is supportive, there is no known specific therapy. Prognosis is good, usually heart
function recovers within weeks.
Schlüsselwörter
Stresskardiomyopathie - Takotsubo-Syndrom - Apical-Ballooning-Syndrom - Broken-Heart-Syndrom
Key word
stress cardiomyopathie - takotsubo syndrome - apical balloning syndrome - broken heart
syndrome
