Takotsubo Cardiomyopathy (TTC)

Sasha Stone. Top of her class, first chair clarinet, and on her way to becoming valedictorian. With her whole life planned out ahead of her you ’d think there would be nothing in her way. Until he shows up.

These separate forms of the condition come with distinct traits that vary from one to the next. Dilated cardiomyopathy, “The most common form, this occurs when the muscle fibers of one or both pumping chambers are weak and unable to contract normally” (“Understand Pediatric” 1). Which means that the heart beats abnormally due to lack of blood flow. Often with DCM the heart is weak and fails because it cannot sufficiently pump blood throughout the body (“Understanding Pediatric” 1). The article on “Understanding Pediatric Cardiomyopathy” states that hypertrophic cardiomyopathy is the second most common form. HCM has a few characteristics that can be mistaken for dilated cardiomyopathy. Thick and stiff muscles may stop the heart from contracting properly, which may narrow the passageways for blood to move out of the heart (“Understanding Pediatric” 1). So, the muscles within the heart thicken to try and help blood flow. In an advanced form of hypertrophic cardiomyopathy, there is a chance that the muscles may thin to try to help the poor pumping action (“Understanding Pediatric” 1). When HCM tries to help the body it, in itself, can cause failure. A

Our case illustrates that TCM mimicks AMI. Although causality cannot be concluded if there is association. Takotsubo cardiomyopathy represents an estimated 1% to 2% of patients who present with an AMI, but low estimate may be because of under recognition. Advanced age and female are the most common known risk factors for developing TCM. The pathophysiology of TCM is unknown but it is believed to be caused by elevated cathecolamines secondary to acute somatic and emotional stressors.(6,7) Other associated risk factors includes intracranial events, severe infection, surgical trauma and respiratory diseases. Among the physical stressors known to be related with TCM are intracranial occasions, infection, surgical injury and respiratory disease.8 For our situation, the respiratory disease may have contributed to the development of TCM

The third defect is Right Ventricular Hypertrophy, which causes a thicker than normal right ventricle. Right ventricular hypertrophy occurs because the heart pumping action becomes harder creating an increase in the hearts work load. Subsequently, this causes a thicker and more muscular heart muscle. This defect causes also causes a reduction in oxygen flowing to the body. The left side of the heart may be underdeveloped from increased work load on the right side of the heart.

This is a structural abnormality of the heart where one or more of the chambers becomes affected. While there are three different types of cardiomyopathy the one associated with taurine deficiency is known as dilated cardiomyopathy which is characterized as enlarged heart chambers and a reduction in contraction ability. Symptoms of this disease include loss of appetite, weakness and depression. DCM, if left untreated, can lead to more serious heart conditions and can cause congestive heart failure. That being said it is very important to make sure that a cat is getting fed the appropriate amount of protein in their diets to greatly reduce the risk of dilated cardiomyopathy. If this disease is caught early enough it is possible to reverse the effects of the disease by making sure to supplement the amino acid taurine into the diet. Due to the discovery of taurine being a factor of this disease pet food companies are forced to make sure there is sufficient amounts of taurine in the feed they market. This has made dilated cardiomyopathy a more rare form of cardiomyopathy and not commonly seen in heart disease cases, it cannot go away completely as there are still genetic factors that play a role in the

Hypertrophic cardiomyopathy is characterized by interventricular septal hypertrophy (in absence of other cardiovascular conditions), causing decrease of left ventricle cavity and potentially leading to outflow obstruction. (1) (6) As a consequence of mutations in several genes encoding for thick and thin filaments which build the cardiac muscle, morphological changes occur leading to tangled, thickened myocardial fibers. It is an important cause of morbidity and mortality. Symptomatology varies a lot, from asymptomatic patients to those with severe cardiac function impairment. Some of the most common symptoms of HCM, which are not specific to this disorder may be: shortness of breath at rest or with exertion, fatigue, chest pain, arrhythmias, dizziness, but not only.

Mr S is tachycardic (Awtry, Jeon, & Ware, 2006), which means that there is disruption of the normal electrical impulse. The presence of atrial fibrillation would suggest that the disruption in electrical activity is occurring in the left atrium rather than the sinus node. If the heart rate has been elevated for a prolonged period it could lead to tachycardia induced cardiomyopathy (TIC) which can lead to HF (Patel & Whittaker, 2007). The increase in resting bpm is a compensatory mechanism used to maintain cardiac output when there is a loss in pumping capacity (Watson, Gibbs, & Lip, 2000). The potential diagnosis of heart disease or failure is further evidenced by no palpable apex beat. This displacement of the apex beat usually indicates cardiomegaly; cardiomegaly is a sign that the heart cannot keep up with its workload and so enlarges to compensate (Madhok et al., 2008). This enlarged heart starts to retain fluid, causing the lungs to become congested and can potentially result in the irregular pulse found on investigation (Kruijt & Turin, 2012). This excessive fluid in the airways can also be the cause of inspiratory crackles. If on examination there appeared to be transudate, this can help to add to the clinical suspicion of chronic heart failure. The character of the crackle can also help in diagnosis; a moist late inspiratory crackle suggests restrictive (alveolar)

828). Early identification is important and it is most commonly caused by aortic stenosis, genetics and hypertension. According to Kupper and Mitchell, “the four main characteristics of hypertrophic CMP are 1) massive ventricular hypertrophy; 2) rapid, forceful contraction of the left ventricle; 3) impaired relaxation; and 4) obstruction to aortic outflow,” (Kupper & Mitchell, 2014, p. 828). Patients can appear asymptomatic or may present with dyspnea that is caused by an elevated diastolic pressure (Kupper & Mitchell, 2014, p. 828). Fatigue, angina, and syncope may occur due to a decrease in cardiac output, an increase in left ventricular muscle mass, or an increase in obstruction to aortic

My thoughts were on the same lines as yours. What caused Ms. Mallard heart problems, was it physical or emotional? I suppose it could have been both. I could not help to wonder if Mr. Mallard had any idea of her sadness, nevertheless; she receive joy twice in in a moment in time his alleged death and her true death.

Takotsubo cardiomyopathy also called as Stress-induced transient cardiomyopathy, apical ballooning syndrome, and broken heart syndrome was first reported in 1991 [1 in Japan, and accounts for 1.2% of acute coronary syndromes (ACS) that present with elevated cardiac biomarkers [1,2,3. The condition is often associated with acute medical illnesses, catastrophic life events, and intense physical or emotional stress [2, 3. Although the pathogenesis of stress-induced cardiomyopathy is not fully understood, the hypothesis includes catecholamine excess [16, coronary vasospasm, micro vascular dysfunction and dynamic mid cavity or left ventricular outflow tract obstruction. Postmenopausal women appear to be at a higher risk for developing the disease as about 80% of Takotsubo cardiomyopathy occurs in postmenopausal women [3].

Stress cardiomyopathy, also called "broken heart syndrome", takotsubo cardiomyopathy and apical air syndrome, is a condition in which intense emotional or physical stress can cause rapid and severe cardiac muscle weakness. Research has proved that stress

Takotsubo cardiomyopathy, also referred to as broken heart syndrome, transient apical ballooning or stress cardiomyopathy is a type of non-ischemic cardiomyopathy in which there is a sudden temporary weakening of the muscular portion of the heart (Zamir, M 2005). It is an increasingly recognized clinical syndrome characterized by transient reversible apical left ventricular dysfunction (Nature Clinical Practice Cardiovascular Medicine, 2008), originally described as a transient occurrence usually after a sudden emotional or physical stress, but more recently other morphologies are now being considered such as multifactorial events involving the vascular (abnormal vasoreactivity, endothelial and microvascular dysfunction),

Takotsubo cardiomyopathy (TC) was originally described in Japan in early 1990s and has been recognized as an increasingly prevalent transient cardiomyopathy triggered by emotional or physical stress. In the past two decades, several variations of this ballooning syndrome have been described including the classic apical ballooning type, a biventricular type , a mid-ventricular type, and finally a basal type [1].

Cardiomyopathy is an uncommon presentation in hyperthyroid patients. There are very few case reports of Throtoxic cardiomyopathy. The mechanism due to which cardiomyopathy occurs in hyperthyroid patients is not very well understood. After extensive literature search, it was found that some of the mechanisms which are described include genomic and non-genomic and direct action of Thyroid hormone on the cardiac muscle may cause cardiomyopathy. In this case report, a case of Multinodular goitre with dilated cardiomyopathy is described.

The aim of this case presentation is to improve the nursing knowledge base and to gain a better understanding of the aetiology, diagnosis, nursing management, and medical therapy used in the treatment of peripartum cardiomyopathy.