Early Identification of Takotsubo syndrome in the emergency department using point-of-care echocardiography: A case series.
Ryan N BarnicleAlexander BraceyMichael SeckoPublished in: Journal of clinical ultrasound : JCU (2020)
Takotsubo syndrome (TS) is an incompletely understood, transient dysfunction of the left ventricle. While acute coronary syndrome must be at the forefront of the differential diagnosis and ruled out appropriately, the possibility of TS can be identified early with point-of-care ultrasonography. The formal diagnostic criteria for TS rely on invasive diagnostic procedures and resolution of symptoms, typically relegating it to a diagnosis of exclusion. However, the acute complications are potentially lethal, and rapid identification is therefore beneficial because these patients can be risk-stratified to higher levels of care. Our case series of three patients, each with early suspected and subsequently confirmed TS, explores how early emergency department ultrasonography can suggest the diagnosis during the emergent workup, and potentially influence disposition decisions, subsequent interventions, and possibly even outcomes.
Keyphrases
- emergency department
- end stage renal disease
- acute coronary syndrome
- ejection fraction
- chronic kidney disease
- newly diagnosed
- magnetic resonance imaging
- healthcare
- prognostic factors
- type diabetes
- computed tomography
- oxidative stress
- magnetic resonance
- depressive symptoms
- percutaneous coronary intervention
- patient reported
- risk factors
- patient reported outcomes
- hepatitis b virus
- pain management
- acute respiratory distress syndrome
- heart failure
- antiplatelet therapy
- quality improvement
- atrial fibrillation
- coronary artery
- pulmonary arterial hypertension
- respiratory failure
- weight loss
- sleep quality
- blood brain barrier
- mechanical ventilation
- extracorporeal membrane oxygenation
- glycemic control