Introduction
Materials and Methods
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diagnosis of TCM syndrome;
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full-text versions available in English or Italian;
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role of the Advanced Practice Nurse in TCM syndrome;
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role of the nurse in TCM syndrome;
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distinguishing characteristics of nursing differential diagnosis in TCM and IMA.
Population | Patients with TCM |
Intervention | Nursing interventions in TCM syndrome |
Outcomes | Differential nursing diagnosis for IMA and TCM with improved disease management and reduction of medical and nursing treatment errors |
Database | String | Limits | Results |
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Medline (PubMed) | Search: (takotsubo) AND (nursing role) (“takotsubo”[All Fields] OR “takotsubo s”[All Fields]) AND ((“nursing”[MeSH Terms] OR “nursing”[All Fields] OR “nursings”[All Fields] OR “nursing”[MeSH Subheading] OR “nursing s”[All Fields]) AND (“role”[MeSH Terms] OR “role”[All Fields])) | None | 7 |
Medline (PubMed) | Search: (takotsubo) AND (nurse) (“takotsubo”[All Fields] OR “takotsubo s”[All Fields]) AND (“nurse s”[All Fields] OR “nurses”[MeSH Terms] OR “nurses”[All Fields] OR “nurse”[All Fields] OR “nurses s”[All Fields]) | None | 18 |
Medline (PubMed) | Search: (emergency room) AND (tako tsubo) (“emergency service, hospital”[MeSH Terms] OR (“emergency”[All Fields] AND “service”[All Fields] AND “hospital”[All Fields]) OR “hospital emergency service”[All Fields] OR (“emergency”[All Fields] AND “room”[All Fields]) OR “emergency room”[All Fields]) AND (“tako”[All Fields] AND “tsubo”[All Fields]) | None | 15 |
Medline (PubMed) | Search: (tako tsubo) AND (emergency) “tako”[All Fields] AND “tsubo”[All Fields] AND (“emerge”[All Fields] OR “emerged”[All Fields] OR “emergence”[All Fields] OR “emergences”[All Fields] OR “emergencies”[MeSH Terms] OR “emergencies”[All Fields] OR “emergency”[All Fields] OR “emergent”[All Fields] OR “emergently”[All Fields] OR “emergents”[All Fields] OR “emerges”[All Fields] OR “emerging”[All Fields]) | None | 82 |
Scopus | (Title-abs-key (takotsubo AND nurse) AND title-abs-key (emergency room) | None | 8 |
Google Scholar | Takotsubo and nurse and emergency room AND nursing role | Scientific articles | 2420 |
Web of Science (WOS) | Takotsubo (All Fields) and nurse (All Fields) | None | 7 |
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studies related to myocardial infarction (IMA);
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studies related to medical interventions and prescriptions rather than nursing management in TCM syndrome;
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patients who did not receive any nursing education and training on TCM syndrome;
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studies that did not investigate the elements that distinguish the nursing differential diagnosis;
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pediatric population.
Results
Author, year | Objective | Design | Sample, setting | Main result |
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PubMed database | ||||
Vriz et al. [2] | To describe the actual incidence and prevalence among patients with acute coronary syndrome, and the recurrence rate of TCM in the emergency department of a community hospital | Observational, prospectic | 25 TCM patients | This study highlights an increase in the incidence rate of TCM in the general population, with a higher prevalence of TCM recurrence rate compared to data reported in previous studies |
Cantey [16] | To describe the story of a woman who is diagnosed with TCM | Observational, case report | Woman, 71 y.o | Description of TCM syndrome and the evolution of the pathology in the woman considered in the case report |
Ripa et al. [9] | Differential diagnosis recognition of TCM vs an acute myocardial infarction (MI) | Observational, case report | Woman, 78 y.o | Based on the limited increase in cardiac enzymes, the absence of coronary lesions, and the presence of typical echocardiographic changes, the Authors suspected a TCM syndrome |
Strachinaru et al. [15] | Diagnosis of TCM in a woman with only an increase in cardiac troponin | Observational, case report | Woman, 83 y.o | TCM recognition in a woman with only increased cardiac troponin without symptoms corresponding to the syndrome |
Padilla et al. [7] | Examination of the pathophysiology, signs and symptoms, diagnosis, and treatment of TCM | Observational, descriptive | 22 subjects with TCM | List of signs and symptoms of TCM and description of some favorable patient outcomes |
Massobrio et al. [14•] | To evaluate the mortality rate and all-cause survival in a series of female patients with TCM compared to STEMI (ST-Segment Elevation Myocardial Infarction) patients of the same age and sex during follow-up | Observational, prospectic | 65 subjects with TCM | The TCM group had a lower mortality rate than the IMA group, which seems to suggest that TCM and IMA are two different clinical entities with different clinical outcomes |
Scopus database | ||||
Sharkey et al. [13] | Comprehensive diagnostic investigations for the unexpected discovery of a catecholamine-producing pheochromocytoma | Observational, descriptive | 2 male subjects of different age: 16 and 66 y.o | Observations show a common link between the occurrence of TCM and elevated catecholamine levels in both male and female patients with the presence of pheochromocytoma |
Web of Science WOS database | ||||
Nyeche and Winokur [4] | Clinical manifestations of TCM | Observational, descriptive | Samples from different studies compared | Elements characterizing the diagnosis of TCM, especially cases of previous surgery |
Griffin and Logue [3] | To describe the diagnostic criteria used for TCM | Observational, descriptive | 22 women with TCM | Factors involved in the diagnosis of TCM in middle-aged women |
Dahlviken et al. [5] | To describe the experiences of women with TCM cardiomyopathy from a short-term perspective | Observational, qualitative | 14 women with TCM | Women suffering from TCM may be a target group for holistic and individual health care with a longer duration of follow-up |
Google Scholar database | ||||
Wallström et al. [10] | Describe and interpret patients' narratives of the long-term stress experienced before the onset of TCM syndrome | Observational, qualitative | 19 subjects with TCM | Long-term stressful circumstances can cause vulnerability to acute psychological or physical stressors and, subsequently, the onset of TCM syndrome |
Sundelin et al. [8] | Describe the stress before and after the onset of TCM syndrome | Observational, mixed method | 20 subjects with TCM | Patients with TCM syndrome reported long-term stress at times with an acute stress trigger before the onset of TCM syndrome. Stress decreased over time but remained high for a considerable number of patients |
Brenner and Powers [11] | Describe TCM syndrome on social stressful events | Observational, case report | Woman, 77 y.o | Widowed woman with stressful event: emergency room course is described |
Swenson et al. [1] | To review the physiology, diagnostics, treatment, and complications of TCM and to report a case study of a patient who developed TCM | Observational, review | Supporting information was obtained through the survey of academic articles on TCM over the past decade | APN is crucial in differentiating between TCM and acute myocardial infarction, heart failure, pulmonary edema, dynamic outflow obstruction, and cardiogenic shock |
Derrick [6] | To describe the clinical manifestations of TCM | Observational, descriptive | Man, 65 y.o | Timely recognition of TCM results in fewer errors and consequences for the patient |
Ghanim et al. [12] | To describe TCM as a result of insect bite | Observational, case report | Woman, 37 y.o | Therapeutic treatment after insect bite of a woman with TCM |
Discussion
Defining characteristics for nursing diagnosis in the differentiation between TCM and IMA | Takotsubo cardiomyopathy (TCM) | Acute myocardial infarction (IMA) |
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Symptoms | • Sudden onset of chest pain [6] • Initial symptom is often dyspnea [6] | Thoracic pain, chest pressure, pain in the arms, shoulder, neck, or jaw [4] |
Onset | • Emotional stress or period of increased physical activity | Blood clot/plaque causing cardiac ischemia [7] |
Nursing history/anamnesis | • History of TCM [13] • Menopause [3] • History of hypertension, hyperlipidemia, and/or atrial arrhythmias [13] • History of previous stroke, gastric bleeding, chronic obstructive bronchopneumopathy [16] • Insect bites [12] • History of pheochromocytoma (rare tumor of the adrenal glands) [13] • History of platelet glycoprotein disorder [11] • Bad financial news [7] • Announcement of tragic news (e.g., cancer diagnosis, death of a family member, natural disasters) [4] • Collisions with motor vehicles [7] • History of previous surgeries [4] • Administration of catecholamine therapy [16] • Use or abstinence from illegal drugs [7] • Absence of atherosclerotic coronary disease or other pathological conditions to explain the observed pattern of temporary ventricular dysfunction (e.g., viral myocarditis) [14•] | • Family history of CAD, heart disease, diabetes, hypertension, smoking, unhealthy LDL levels, dietary fat. Age > 65 years [8] |
ECG reading | • Transient elevation of the ST segment or inversion of the T wave prolonged QT interval [1] • Malignant ventricular arrhythmias [1] | ST-segment elevation or depression. Reversal of T wave. Prolonged QT interval associated with cardiac death [1] |
Blood biomarkers to be reported to the medical specialist | • Small, rapid increase in CPK and/or blood levels of troponin 1 [3] | Troponin 1 and troponin increased. Increased levels of CPK and CK-MB [5] |