TAKOTSUBO SYNDROME IN POSTMENOPAUS WOMEN: PATHOPHYSIOLOGICAL PROCESSES AND IMPORTANCE OF DIFFERENTIAL DIAGNOSIS (Atena Editora)

Abstract

Goal: The present study consists of discussing the factors that predispose to Takotsubo Syndrome in postmenopausal women and the importance of the differential diagnosis for the application of an early management. Methods: Bibliographic review developed from October to November 2022, with a search in the PubMed and Scielo databases, using the descriptors "post-menopausal women", "takotsubo cardiomyopathy", "diagnosis" and "differential diagnosis". 201 articles were found and selected, after the inclusion and exclusion criteria, 16 articles to compose the study. Review: Studies indicate that Takotsubo Syndrome (TST) has a possible neurogenic origin, triggered by stress, both emotional and physiological. This stress generates endothelial dysfunction, which causes changes in vasodilation and vasoconstriction. In post-menopause, there is a lack of sexual steroids, which have an influence on endothelial preservation in response to stress responses. Steroids such as estrogen attenuate the vasoconstriction caused by catecholamines; it is believed that the reduction of this hormone has a great influence on the pathophysiology of this disease. Acute Coronary Syndrome (ACS) is the main differential diagnosis of TTS, since they are very similar in terms of clinical picture, electrocardiographic changes and elevation of cardiac biomarkers. Through coronary angiography, it is possible to differentiate TTS from ACS, as obstruction of the coronary arteries indicates ACS. Final Considerations: It is necessary to expand research on the pathogenesis of TTS, in order to establish the best way to intervene in the evolution of this syndrome, since it is not a benign condition and without interventions it can result in ventricular dysfunction.