Dissociation Between Severity of Takotsubo Cardiomyopathy and Presentation With Shock or Hypotension

BACKGROUND: Takotsubo cardiomyopathy (TTC) is increasingly well‐recognized as a cause of chest‐pain syndromes, especially in aging females. The most common complications of TTC occur in the first 24 hours post onset of symptoms and include shock and/or arrhythmias. HYPOTHESIS: We tested the hypothesis that the severity of early hypotension in TTC reflects the extent of myocardial involvement and dysfunction. METHODS: In 80 consecutive TTC patients, correlates of blood pressure on the day of admission were sought via univariate followed by multivariate analysis. RESULTS: Mean systolic blood pressure (SBP) on day 1 was 120 ± 24 (SD) mm Hg. During the first 3 days of admission, 39% of patients had SBP