Takotsubo cardiomyopathy (diagnostic criteria)

Last revised by Bahman Rasuli on 29 Oct 2021

Citation, DOI, disclosures and article data

Citation:

Carroll D, Rasuli B, Takotsubo cardiomyopathy (diagnostic criteria). Reference article, Radiopaedia.org (Accessed on 19 Apr 2024) https://doi.org/10.53347/rID-94359

DOI:

https://doi.org/10.53347/rID-94359

Permalink:

https://radiopaedia.org/articles/94359

rID:

94359

Article created:

28 Oct 2021, David Carroll ◉

Disclosures:

At the time the article was created David Carroll had no recorded disclosures.

View David Carroll's current disclosures

Last revised:

29 Oct 2021, Bahman Rasuli ◉

Disclosures:

At the time the article was last revised Bahman Rasuli had no recorded disclosures.

View Bahman Rasuli's current disclosures

Revisions:

2 times, by 2 contributors - see full revision history and disclosures

Systems:

Cardiac

Sections:

Classifications

Tags:

echo, cardiac, cardiology, takotsubo, heart, emergency, critical

Synonyms:

Takotsubo cardiomyopathy, alternatively Takotsubo syndrome, is a primary acquired cardiomyopathy characterized by transient left ventricular dysfunction. Several sets of diagnostic criteria exist and are variably utile in various clinical and research settings.

International Takotsubo Diagnostic Criteria (2018)

evidence of transient left ventricular dysfunction with abnormal wall motion in an apical, focal, midventricular, or basal distribution ²
- classic description as apical "ballooning" or dyskinesis
- typically involves more than one discrete coronary artery territory
- involvement of the right ventricle may also occur
a preceding trigger, which may be physical and/or emotional, may be present but is not required
triggers may also include neurologic conditions or a pheochromocytoma
- subarachnoid hemorrhage, status epilepticus, and ischemic stroke are potential culprits
usually associated with new electrocardiographic abnormalities, may rarely be absent
- these include ST segment deviation, T wave inversion, and prolongation of the corrected QT interval
moderate elevation of cardiac biomarkers such as creatine kinase and troponin common
- marked elevation of brain natriuretic peptide concentrations also common
may exist concomitantly with significant coronary artery disease
absence of factors suggestive of infectious myocarditis
- may be evaluated with cardiac magnetic resonance imaging (MRI)
predilection to affect postmenopausal females

Revised Mayo Clinic diagnostic criteria (2008)

transient wall motion abnormalities involving the left ventricular mid segments with or without apical involvement, involved territory extends beyond a discrete epicardial coronary artery vascular distribution, and a stressful trigger is typically (but not obligatorily) present ¹
absence of acute plaque rupture demonstrated on coronary angiography and absence of obstructive coronary artery disease
new ST segment elevation and/or T wave inversion demonstrated on an electrocardiogram or a modest rise in troponin levels
no evidence of myocarditis or a pheochromocytoma