Takotsubo cardiomyopathy: an Australian single centre experience with medium term follow up

Background:  Takotsubo cardiomyopathy (TC) is increasingly recognised in patients presenting with features of acute coronary syndrome. We present a single centre experience of TC with medium term follow up. Methods:  Fifty‐two consecutive patients presenting with a diagnosis of TC were included. The clinical presentation, complications, baseline and follow‐up echocardiograms and cardiac magnetic resonance imaging were analysed. Results:  Fifty‐one patients were female. A stressful event preceded presentation in 37 (71%) patients. Chest pain was the most common symptom (83%). Two patients presented with an out‐of‐hospital cardiac arrest. ST segment elevation (40%) and global T wave inversion (44%) were the most frequent electrocardiogram changes. Left ventricular assessment demonstrated typical apical ballooning in 41 patients and 11 patients demonstrated the mid‐wall variant. In‐hospital complications occurred in 11 patients (21%) and included acute pulmonary oedema ( n  = 2), cardiogenic shock ( n  = 5); two of whom had a significant left ventricular outflow gradient, atrial fibrillation ( n  = 1), left ventricular thrombus ( n  = 2) and a cerebrovascular event ( n  = 2). Left ventricular function at presentation and follow up was compared in 40 patients. The mean ejection fraction in this group at presentation was 47% (20–70%) compared with that at follow up of 63% (44–76%). There were no significant complications or recurrences at follow up. Conclusions:  While TC is a reversible condition with low rates of complications and recurrence at follow up it is, as demonstrated in our cohort, associated with significant in‐hospital morbidity in a proportion of patients.