Long-term follow-up of Tako-Tsubo-like syndrome: a retrospective study of 22 cases

OBJECTIVES: To assess the late outcome of the Tako-Tsubo like syndrome in a community hospital in northern Italy. METHODS AND RESULTS: We reviewed 2233 patients who were admitted from 2001 to 2006 with diagnosis of acute coronary syndrome. Twenty-two patients (1%) presenting clinical and instrumental characteristics of Tako-Tsubo like syndrome were included in the study and prospectively underwent clinical and echocardiographic follow-up. All patients were women; aged 76 +/- 7 years; 82% experienced a stress before the acute episode; 50% reported chest pain and dyspnoea also days before. Mean troponin peak value was 3.6 +/- 3.3 microg/l. Mean acute echocardiographic ejection fraction was 40 +/- 7%. Eighteen percent of them presented major in-hospital complications. At a mean follow-up time of 27 +/- 19 months, 2 patients (9%) died because of ischemic stroke and renal failure, respectively, 14 (63%) were asymptomatic, 1 (5%) declared a paroxysmal episode of atrial fibrillation, and 5 (23%) still lamented dyspnoea or atypical chest pain. In all patients, typical apical ballooning disappeared and an increase in mean ejection fraction to 60 +/- 4% was observed. CONCLUSION: After complications are promptly recognized and treated in the acute phase, prognosis of Tako-Tsubo like syndrome appears to be good at long-term follow-up, with a complete recovery of normal left ventricular function.