In the end, they concluded their data supported "the theory of catecholamine mediation of these myocardial changes in man and of the lethal potential of stress through its effect on the heart".The first studied case of takotsubo cardiomyopathy was in Japan in 1991 by Sato et al. More cases of the syndrome appeared in Japan within the next decade, although western medicine had still not acknowledged it. The syndrome finally occurred in 1997 when Pavin, et al., wrote about two cases of "reversible LV dysfunction precipitated by acute emotional stress". The western world had not heard of such a thing at the time, as it was incredibly rare and often misdiagnosed. The Japanese at last reported about the syndrome to the west in 2001 under the name "transient LV apical ballooning" though at this point the west had already heard of numerous cases. The syndrome reached international audiences through the media in 2005 when the New England Journal of Medicine wrote about the syndrome.In the bible, when Jacob was told his long lost son, Joseph, is still alive, "his heart faltered, because he did not believe them". The medieval  commentator, Nachmanides, further explains: "This condition is known when joy suddenly comes upon one, and it is mentioned in the books of medicines that old or feeble persons cannot withstand the shock, for many of them faint when joy comes to them very suddenly.
Those signs - in non-neurogenic shock -  would include: tachycardia (increased heart rate), tachypnea (increased breath rate), sweating, and adaptive vasoconstriction, which serves in other forms of shock to shunt blood away from the extremities and to the vital organs. In neurogenic shock, the body loses its ability to activate the SNS so that only parasympathetic tone remains. The resulting loss of sympathetic tone, which plays a major role in other forms of shock, is responsible for the unique and atypical features mentioned above.<ref name=incidence>Mallek JT; Inaba K;  et al. (2012). "The Incidence of Neurogenic Shock after Spinal Cord Injury in Patients Admitted to a High-Volume Level I Trauma Center". The American Surgeon. 78 (5): 623–626. doi:10.1177/000313481207800551. PMID 22546142. S2CID 12758597.</ref>

Treatment
Dopamine (Intropin) is often used in combination with other vasopressors. Dopamine is not the best first-line vasopressor as it increases the chance of arrhythmias. Vasopressin (antidiuretic hormone, ADH) is another vasopressor often used in combination with norepinephrine 
Certain vasopressors (ephedrine, norepinephrine). Norepinephrine(Levophed) is the most common first-line vasopressor for people who dont respond well to other hypotension treatments such as fluid resuscitation. Atropine is administered for bradycardia. It acts on the vagus nerve so it its not effective in heart transplant patients as the vagus nerve is severed during the transplant

References


== External links ==