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“Reverse McConnell’s Sign”: Interpreting Interventricular Hemodynamic Dependency and Guiding the Management of Acute Heart Failure during Takotsubo Cardiomyopathy

Although most patients with Takotsubo cardiomyopathy (TTC) have benign clinical course and prognosis, TTC can induce acute heart failure and hemodynamic instability. TTC mimics the clinical features of acute anterior wall myocardial infarction (AMI). Bedside clinicians often have a diagnostic dilemm...

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Detalles Bibliográficos
Autores principales: Liu, Kan, Sun, Zhongxia, Wei, Tiemin
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Libertas Academica 2015
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4373721/
https://www.ncbi.nlm.nih.gov/pubmed/25861229
http://dx.doi.org/10.4137/CMC.S18756
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author Liu, Kan
Sun, Zhongxia
Wei, Tiemin
author_facet Liu, Kan
Sun, Zhongxia
Wei, Tiemin
author_sort Liu, Kan
collection PubMed
description Although most patients with Takotsubo cardiomyopathy (TTC) have benign clinical course and prognosis, TTC can induce acute heart failure and hemodynamic instability. TTC mimics the clinical features of acute anterior wall myocardial infarction (AMI). Bedside clinicians often have a diagnostic dilemma when cardiac catheterization and angiography are either contraindicated or can cause potential adverse consequences. Misdiagnosing TTC as AMI will lead to initiation of harmful pharmacological or device-based treatment, which worsens hemodynamic compromise. Therefore, understanding and interpreting the unique pathophysiological and hemodynamic features of TTC in a better manner becomes crucial to guide effective clinical management of acute heart failure/cardiogenic shock during TTC. We review recent advances in echocardiographic diagnosis of TTC and its role in guiding bedside management of acute heart failure and cardiogenic shock, with specific focus on the interpretation of discrepant, but reciprocally dependent, left and right ventricular hemodynamics during acute stages of TTC.
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spelling pubmed-43737212015-04-08 “Reverse McConnell’s Sign”: Interpreting Interventricular Hemodynamic Dependency and Guiding the Management of Acute Heart Failure during Takotsubo Cardiomyopathy Liu, Kan Sun, Zhongxia Wei, Tiemin Clin Med Insights Cardiol Review Although most patients with Takotsubo cardiomyopathy (TTC) have benign clinical course and prognosis, TTC can induce acute heart failure and hemodynamic instability. TTC mimics the clinical features of acute anterior wall myocardial infarction (AMI). Bedside clinicians often have a diagnostic dilemma when cardiac catheterization and angiography are either contraindicated or can cause potential adverse consequences. Misdiagnosing TTC as AMI will lead to initiation of harmful pharmacological or device-based treatment, which worsens hemodynamic compromise. Therefore, understanding and interpreting the unique pathophysiological and hemodynamic features of TTC in a better manner becomes crucial to guide effective clinical management of acute heart failure/cardiogenic shock during TTC. We review recent advances in echocardiographic diagnosis of TTC and its role in guiding bedside management of acute heart failure and cardiogenic shock, with specific focus on the interpretation of discrepant, but reciprocally dependent, left and right ventricular hemodynamics during acute stages of TTC. Libertas Academica 2015-03-23 /pmc/articles/PMC4373721/ /pubmed/25861229 http://dx.doi.org/10.4137/CMC.S18756 Text en © 2015 the author(s), publisher and licensee Libertas Academica Ltd. This is an open-access article distributed under the terms of the Creative Commons CC-BY-NC 3.0 License.
spellingShingle Review
Liu, Kan
Sun, Zhongxia
Wei, Tiemin
“Reverse McConnell’s Sign”: Interpreting Interventricular Hemodynamic Dependency and Guiding the Management of Acute Heart Failure during Takotsubo Cardiomyopathy
title “Reverse McConnell’s Sign”: Interpreting Interventricular Hemodynamic Dependency and Guiding the Management of Acute Heart Failure during Takotsubo Cardiomyopathy
title_full “Reverse McConnell’s Sign”: Interpreting Interventricular Hemodynamic Dependency and Guiding the Management of Acute Heart Failure during Takotsubo Cardiomyopathy
title_fullStr “Reverse McConnell’s Sign”: Interpreting Interventricular Hemodynamic Dependency and Guiding the Management of Acute Heart Failure during Takotsubo Cardiomyopathy
title_full_unstemmed “Reverse McConnell’s Sign”: Interpreting Interventricular Hemodynamic Dependency and Guiding the Management of Acute Heart Failure during Takotsubo Cardiomyopathy
title_short “Reverse McConnell’s Sign”: Interpreting Interventricular Hemodynamic Dependency and Guiding the Management of Acute Heart Failure during Takotsubo Cardiomyopathy
title_sort “reverse mcconnell’s sign”: interpreting interventricular hemodynamic dependency and guiding the management of acute heart failure during takotsubo cardiomyopathy
topic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4373721/
https://www.ncbi.nlm.nih.gov/pubmed/25861229
http://dx.doi.org/10.4137/CMC.S18756
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