Table 4.
Differentiation for nursing diagnosis between TCM and IMA
| Defining characteristics for nursing diagnosis in the differentiation between TCM and IMA | Takotsubo cardiomyopathy (TCM) | Acute myocardial infarction (IMA) |
|---|---|---|
| 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] |
CAD coronary artery disease, CPK creatine phosphokinase, CK-MB creatine kinase MB (blood) isoenzyme, ECG electrocardiogram, LDL low-density lipoproteins