Cardiac rupture with high mortality a rare complication of Takotsubo syndrome among elderly females: Study

For this purpose, they conducted a systematic search of online databases to identify case reports of patients with TS complicated by CR from inception to October 2023.

The researchers reported the following findings:

• Forty-four subjects (40 females; 4 males) with a median age of 75 years, of White/Caucasian (61%) or East Asian/Japanese (39%) ethnicity.
• An emotional trigger was present in 34% of subjects, and an apical ballooning pattern was observed in all cases (100%).
• ST-segment elevation was reported in 93% of 42 cases, with the anterior myocardial segments (88%) being the most compromised, followed by lateral (62%) and inferior (33%) segments.
• The median time to cardiac rupture was 48 hours since admission, with the left ventricular free wall 57% being the most frequent site of perforation.
• In 36% of cases, surgery was attempted, and 64% of patients did not survive.

The researchers suggest that while cardiac rupture is uncommon in Takotsubo syndrome, healthcare providers should remain vigilant regarding this serious complication to promptly identify high-risk patients. Early detection of cardiac rupture, timely decompression of cardiac tamponade if present, and prompt consideration of cardiac surgery if necessary may reduce mortality in these patients confronting a critical outcome.

"The complete understanding of the pathophysiological mechanism behind cardiac rupture in Takotsubo syndrome remains elusive, and there is a need for additional research to identify ways to reduce mortality rates in this population," the researchers concluded.

Reference:

Denicolai, M., Morello, M., Del Buono, M. G., Sanna, T., Agatiello, C. R., & Abbate, A. (2024). Cardiac rupture as a life-threatening outcome of Takotsubo syndrome: A systematic review. International Journal of Cardiology, 132336. https://doi.org/10.1016/j.ijcard.2024.132336