Dr Cindy Towns
Takotsubo cardiomyopathy is thought to account for 1-2 percent of acute coronary syndromes (ACS), ACS being medicalese for what most people would call ‘heart attacks’.
Takotsubo as a diagnosis got its name from a Japanese Octopus pot which looks a little like the Takotsubo heart on echocardiography (essentially an ultrasound). Takotsubo has some more creative synonyms, including acute stress cardiomyopathy, broken heart syndrome and ‘scared to death’. It mimics a traditional heart attack but is not due to coronary artery disease. Rather, the structure of the heart balloons in places. Classically, physically or emotionally distressing events precede the presentation, but the exact mechanism of the condition remains speculative. It has been associated with earthquakes in both Japan and New Zealand.
[Read more…] about Takotsubo cardiomyopathy – and a little art with our medicine
All medical professionals will recognise a large number of patients who present with symptoms that are difficult to explain or are out of proportion to the condition from which they appear to suffer. These patients present a serious challenge to a medical system which has become increasingly guided by scientific evidence. Under this western medical model, a patient will present with symptoms which can be investigated with various tests or scans, the investigations will confirm a diagnosis and then appropriate treatment can be instituted. Appropriate treatment is considered to be that which has been proven beneficial by scientific method.
When I started my career shift from Hospital Medicine to Palliative Medicine in 2004, my mother asked me “Why in the world do you want to work with people who are going to die? That is so depressing.” My answer then and my answer now is the same. “I am a doctor, I already work with people who are dying—and I know it can be done better.”
originating in the forearm, specialised nerve endings (including Merkel’s discs, Pacinian, Meissner’s and Ruffini’s corpuscles and hair follicle receptor lanceolate endings) which detect light or deep pressure, position, vibration, shapes, edges—hands that are trained to grasp, squeeze, pinch, pat, poke, point, that can stroke a polished surface of marble or plaster or a young baby’s skin and on that smoothness feel the merest rough patch of, say, a tiny grain of salt. Yet by the time a child in our culture is about seven years of age, her hands are already semi-retired. Why?
