Wednesday, July 20, 2011


There is a medical syndrome, first described by the Japanese about 10 years ago, called the Tako-tsubo cardiomyopathy. It affects main post-menopausal females in Japan. Those affected usually had a severe emotional shock, and ended up with markedly distorted ventricular aneurysmal dilatations. detected on MRI ( magnetic resonance imaging ).
Well, the latest issue of the Journal of the American medical Association carried a large study on this rather rare condition. The workers from University of Leipzig Health Center ( we are seeing more and more papers out of the former East Germany ). Led by Dr Ingo Eitel, they studied 256 patients who had MRI of their heart for evaluation after a stressful period. The MRI showed severe ballooning of certain portions of the heart. It can involve either ventricles. The structural defect is usually anuerysmal dilatation of the LV apex, free wall, biventicular or right ventricular. A repeat MRI 6 months later, showed that these changes had all returned to normal. 70% ( not all ) of these patients had a severe emotional stress preceeding the "cardiac" problem. All of them had no ECG or biochemical markers of any acute coronary syndrome. 80% of them were post-menopausal ( not all ), and there were some 10% males as well.
No specific therapy is required. They recover well.
Looks like this is a rather new and yet not so well defined cardiac syndrome. The features of post-menopausal females, severe emotional stress, absence of signs and biochemical markers of acute coronary syndrome or other cardiac disease, the presence of characteristic changes on the MRI of the heart, and of course the most important feature, complete recovery in 6 months, gives basis for a syndrome.
I can see that the features are at best, vague, and may form a waste paper basket for many poorly defined cardiac problems, in stressful, post-menopausal females.
However, it is good to know.

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