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Clinical management in the takotsubo syndrome.

Forskningsöversiktsartikel
Författare Sandeep Jha
Rickard Zeijlon
Aaron Shekka Espinosa
Jessica Alkhoury
Jonatan Oras
Elmir Omerovic
Björn Redfors
Publicerad i Expert review of cardiovascular therapy
Volym 17
Nummer/häfte 2
Sidor 83-93
ISSN 1744-8344
Publiceringsår 2019
Publicerad vid Wallenberglaboratoriet
Sidor 83-93
Språk en
Länkar dx.doi.org/10.1080/14779072.2019.15...
www.ncbi.nlm.nih.gov/entrez/query.f...
Ämneskategorier Kardiovaskulär medicin

Sammanfattning

Takotsubo syndrome (TS) is an increasingly recognized acute heart failure syndrome which is self-limiting in most cases but can result in life-threatening complications. TS is difficult to distinguish from acute myocardial infarction (AMI) early in the disease course and currently lacks evidence-based treatment recommendations. Areas covered: Based on the available literature this systematic review discusses the clinical management of patients with TS during (i) the diagnostic workup; (ii) acutely after establishing the TS diagnosis; and (iii) after recovery of cardiac function. Expert commentary Since TS is self-limiting in most cases it is recommended to refrain from unnecessary treatment (the do no harm principle) when managing patients with TS. The management of patients with TS should focus on careful monitoring of ECG and hemodynamics, and on preventing and treating complications. Because catecholamine-mediated inotropic overstimulation is implicated in the pathogenesis of TS, and because inotropic drugs have been associated with worse outcomes for patients with TS, we recommend the treating physician to avoid these drugs. Instead, mechanical assist devices should be considered early for patients with TS who develop cardiogenic shock with signs of end-organ hypo-perfusion.

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