Abstract

FARIA, Sofia; CORDEIRO, Cátia  and  CAVADAS, Luís Filipe. Takotsubo syndrome in family medicine: a case report. Rev Port Med Geral Fam [online]. 2018, vol.34, n.6, pp.408-412. ISSN 2182-5173.  https://doi.org/10.32385/rpmgf.v34i6.12048.

Introduction: Takotsubo syndrome is a transient systolic dysfunction of the left ventricle, which mimics acute myocardial infarction in the absence of coronary artery disease. It is more common in postmenopausal women with suspected acute coronary syndrome (ACS) and electrocardiographic abnormalities that are not proportional to the values of cardiac markers. An emotional or physical trigger is often present, and in these cases the family physician can play an important role in the diagnosis and follow-up. Case study: The authors describe the case of a 49-year-old woman admitted to the emergency room with suspected ACS, presenting with chest pain, dyspnea and nausea. Acute heart failure was observed, with a severe compromise of left ventricular systolic function, but in the absence of coronary disease. A favorable clinical evolution was observed, with a complete recovery of cardiac function, and the diagnosis of Takotsubo syndrome was made. In this context, the general practitioner (GP) knowledge about this patient was able to identify work and family stress as probable triggers of this syndrome, and played an important role on anxiety management and follow-up. Comment: After this event, the patient remained asymptomatic, and was essentially given general supportive care. Thus, the GP will be responsible for the symptomatic control of anxiety and emotional disorders, as well as for the monitoring of signs and/or symptoms of heart failure. The GP will play a preventive role, by identifying and acting timely on putative triggers, promoting and reinforcing the importance of adopting healthy habits and lifestyles, and monitoring the patient’s biopsychosocial health status, in order to avoid and minimize long-term complications.

Keywords : Takotsubo syndrome; Cardiomyopathy; Primary health care; Cardiology.

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