ECG changes and prognosis of Takotsubo cardiomyopathy Patompong Ungprasert MD, Narat Srivali MD PII: DOI: Reference:

S0735-6757(15)00083-2 doi: 10.1016/j.ajem.2015.02.021 YAJEM 54808

To appear in:

American Journal of Emergency Medicine

Received date: Accepted date:

10 February 2015 11 February 2015

Please cite this article as: Ungprasert Patompong, Srivali Narat, ECG changes and prognosis of Takotsubo cardiomyopathy, American Journal of Emergency Medicine (2015), doi: 10.1016/j.ajem.2015.02.021

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ACCEPTED MANUSCRIPT Title page Title: ECG changes and prognosis of Takotsubo cardiomyopathy

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Authors: *Patompong Ungprasert, MD1, Narat Srivali, MD2

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Article type: Letter to editor

1 Division of rheumatology, Mayo Clinic, Rochester, MN, USA

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2 Division of pulmonology and critical care medicine, Mayo Clinic, Rochester, MN, USA

*Corresponding author; P.U.: [email protected], [email protected]

Funding: None

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Conflict of interest statement for all authors: We do not have any financial or nonfinancial potential conflicts of interest.

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Authors’ contributions: All authors had access to the data and a role in writing the manuscript.

ACCEPTED MANUSCRIPT ECG changes and prognosis of Takotsubo cardiomyopathy

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We read the article “Stimulant-related Takotsubo cardiomyopathy” by Butterfield et al. [1] in the previous issue of the American Journal of Emergency medicine with great interest. The authors described a very interesting case of Takotsubo cardiomyopathy (TC) associated with cocaine abuse. The patient did have a remarkable electrocardiogram (ECG) changes and was successfully treated with conservative management. We would like to emphasize two important issues related to this case presentation. First, although the majority of patients with TC have ECG changes at presentation, as seen in the this case, up to 30% of patients could have a completely normal ECG [2, 3]. Thus, a normal ECG does not always rule out the diagnosis of TC. Second, TC is not always a benign condition and sometimes an aggressive intervention is required as a recent systematic review had demonstrated an in-hospital mortality of up to 3% [2].

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Reference 1. Butterfield M, Riguzzi C, Frenkel O, Nagdev A. Stimulant-related Takotsubo cardiomyopathy. Am J Emerg Med. 2014 Sep 6 [Epub ahead of print] 2. Ahmed S, Ungprasert P, Ratanapo S, Hussain T, Riesenfeld EP. Clinical characteristics of takotsubo cardiomyopathy in north america. N Am J Med Sci. 2013 Feb;5(2):77-81. 3. Pelliccia F, Parodi G, Greco C, Antoniucci D, Brenner R, Bossone E, et al. Comorbidities Frequency in Takotsubo Syndrome: An International Collaborative Systematic Review Including 1,109 Patients. Am J Med. 2015 Feb 3 [Epub ahead of print]

Electrocardiogram changes and prognosis of takotsubo cardiomyopathy.

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