Specific Findings of the Standard 12-Lead ECG in Patients With `Takotsubo' Cardiomyopathy Comparison With the Findings of Acute Anterior Myocardial Infarction

Riyo Ogura; Yoshikazu Hiasa; Takefumi Takahashi; Koji Yamaguchi; Kensuke Fujiwara; Yoshikazu Ohara; Teru Nada; Tatsuro Ogata; Kanji Kusunoki; Kenichiro Yuba; Shinobu Hosokawa; Koichi Kishi; Ryuji Ohtani

doi:10.1253/circj.67.687

Clinical Investigation

Specific Findings of the Standard 12-Lead ECG in Patients With `Takotsubo' Cardiomyopathy

Comparison With the Findings of Acute Anterior Myocardial Infarction

Riyo Ogura, Yoshikazu Hiasa, Takefumi Takahashi, Koji Yamaguchi, Kensuke Fujiwara, Yoshikazu Ohara, Teru Nada, Tatsuro Ogata, Kanji Kusunoki, Kenichiro Yuba, Shinobu Hosokawa, Koichi Kishi, Ryuji Ohtani

Author information

Riyo Ogura
Division of Cardiology, Tokushima Red Cross Hospital
Yoshikazu Hiasa
Division of Cardiology, Tokushima Red Cross Hospital
Takefumi Takahashi
Division of Cardiology, Tokushima Red Cross Hospital
Koji Yamaguchi
Division of Cardiology, Tokushima Red Cross Hospital
Kensuke Fujiwara
Division of Cardiology, Tokushima Red Cross Hospital
Yoshikazu Ohara
Division of Cardiology, Tokushima Red Cross Hospital
Teru Nada
Division of Cardiology, Tokushima Red Cross Hospital
Tatsuro Ogata
Division of Cardiology, Tokushima Red Cross Hospital
Kanji Kusunoki
Division of Cardiology, Tokushima Red Cross Hospital
Kenichiro Yuba
Division of Cardiology, Tokushima Red Cross Hospital
Shinobu Hosokawa
Division of Cardiology, Tokushima Red Cross Hospital
Koichi Kishi
Division of Cardiology, Tokushima Red Cross Hospital
Ryuji Ohtani
Division of Cardiology, Tokushima Red Cross Hospital

Keywords: Cardiomyopathy, Electrocardiography, Myocardial infarction (acute)

JOURNAL FREE ACCESS

2003 Volume 67 Issue 8 Pages 687-690

DOI https://doi.org/10.1253/circj.67.687

Details

Abstract

The clinical course of `Takotsubo' cardiomyopathy closely resembles that of acute myocardial infarction (AMI) and coronary angiography (CAG) is usually performed to distinguish the 2 conditions during the acute phase. The present study was designed to determine whether the standard 12-lead electrocardiogram (ECG) findings could help to distinguish `Takotsubo' cardiomyopathy from anterior AMI. The study group comprised 13 patients with `Takotsubo' cardiomyopathy and 13 consecutive patients with anterior AMI. Patients with `Takotsubo' cardiomyopathy had abnormal Q waves less frequently than patients with anterior AMI (15% vs 69%, p=0.008). No reciprocal changes were seen in the inferior leads in patients with `Takotsubo' cardiomyopathy (p=0.0003). The ratio of ST-segment elevation in leads V_4-6 to V_1-3 (ΣSTeV_4-6/V_1-3) was significantly higher in patients with `Takotsubo' cardiomyopathy (1.55±0.53 vs 0.57±0.58, p=0.0004). The QTc interval was significantly longer in patients with `Takotsubo' cardiomyopathy. The absence of reciprocal changes, absence of abnormal Q waves, and a ΣSTeV_4-6/V_1-3 ≥1 all showed a high sensitivity and specificity for diagnosing `Takotsubo' cardiomyopathy. Furthermore, the combination of the absence of reciprocal changes and a ΣSTeV_4-6/V _1-3 ≥1 had a greater specificity (100%) and overall accuracy (91%) than either criteria. Therefore, the standard 12-lead ECG on admission can help to distinguish `Takotsubo' cardiomyopathy from anterior AMI. (Circ J 2003; 67: 687 - 690)

Corresponding author

Register with J-STAGE for free!