RECURRENT TAKOTSUBO CARDIOMYOPATHY: THE ROLE OF ADRENERGIC BLOCKADE

Abstract

(This article may be cited as Brodsky Jordan, Katz Jonathan , James David , Samuel Ossama. Recurrent Takotsubo Cardiomyopathy:The Role of Adrenergic Blockade E-Journal of cardiology 2011;1(1):29-39.)

Background/Objectives: There is no evidence based or universally agreed upon guidelines in the treatment of recurrent Takotsubo Cardiomyopathy. Most patients present with symptoms similar to that of acute coronary syndrome and are therefore treated according to acute coronary syndrome management guidelines. This systematic review case series illustrates one of the first cases of reoccurring Takotsubo Cardiomyopathy described in the literature and focus on pathogenesis and proposed treatments.

Methods: We analyzed two cases of recurrent Takotsubo Cardiomyopathy and the implemented treatment, as well as performed an in depth review of the current literature of Takotsubo Cardiomyopathy.

Results: Although various studies reported a low incidence of Takotsubo Cardiomyopathy, the actual rate is likely higher due to under reporting or misdiagnosis as acute coronary syndrome. In the reviewed cases, adrenergic blockade were continued long-term which likely protected against recurrent Takotsubo Cardiomyopathy.

Conclusions: Adrenergic blockade therapy may reduce the likelihood of recurrent episodes of Takotsubo Cardiomyopathy. There may be a role for continuation of adrenergic blockade with either beta-blockers or combined alpha and beta-blockers indefinitely in the absence of contraindications or intolerance.