Stress cardiomyopathy, also referred to as Takotsubo cardiomyopathy, is an increasingly recognized clinical syndrome characterized by acute reversible apical ventricular dysfunction. Stress cardiomyopathy, also called apical ballooning syndrome, broken heart syndrome, takotsubo cardiomyopathy, and stress-induced cardiomyopathy, is generally characterized by transient systolic dysfunction of the apical and/or mid segments of the left ventricle that mimics myocardial infarction, but in the absence of obstructive coronary artery disease.

Background: Acute Myocardial Infarction (MI) is a life threatening condition responsible for over 85% of the deaths all over the world. The management of MI has to be done on an emergency footing, without losing any time. The standard protocol involves thrombolysis in these patients. However, not all the thrombolysis procedures turn out to be successful. This study was done to explore the prevalence and risk factors associated with the success of thrombolysis.

This was a multicenter, prospective, observational study that assessed the characteristics of patients with Nonvalvular Atrial Fibrillation (NVAF) admitted to internal medicine units in Galicia, Spain, as well as the antithrombotic treatment prescribed prior to hospital admission. Demographic characteristics, cardiovascular risk factors, polypharmacy, comorbidity, functional status and reasons for hospitalization were recorded for patients with NVAF admitted between January 2016 and January 2017. The antithrombotic treatment received by patients prior to hospital admission and the reasons for using this treatment were also analyzed. A total of 1419 patients were included (mean age 82.1 years; 50% male). The mean (standard deviation) number of chronic diseases per patient was 4.11(2.14) and the number of drugs being taken was 9.66(4.60). The mean CHA2DS2-VASc score was 3.09(1.26). NVAF-related hospitalizations accounted for 37.5% of all hospital admissions, with heart failure the most common reason for hospitalization (31.4%). Most patients (75.1%) with NVAF were on anticoagulants at the time of admission and direct oral anticoagulants accounted for 13.9% of anticoagulants. Functional status was the only factor associated with the use of anticoagulation therapy. In conclusion, patients with NVAF admitted to Galician internal medicine units are a diverse population. More than one third are hospitalized for causes related to NVAF, while one in four is not receiving the appropriate antithrombotic therapy. The data suggest that, when primary care physicians or a specialist prescribe antithrombotic therapy, the patient’s functional status is more relevant than established risk factors to their decision-making.