Det är cirka två procent av de patienter som insjuknar med symtom förenliga med akut kranskärlssjukdom (AKS) som istället drabbas av takotsubo syndrom (TS). TS anses vara kraftigt underdiagnostiserat och även ofta felaktigt diagnostiserat. Brister i rekommendationer och avsaknad av riktlinjer, i kombination med att patienterna inte är särskilt vanligt förekommande, kan påverka förutsättningarna för sjuksköterskor att erbjuda dessa patienter evidensbaserad och personcentrerad omvårdnad.   Syftet med studien var att beskriva sjuksköterskors erfarenheter av omvårdnad vid takotsubo syndrom.   Metoden var en kvalitativ, deskriptiv intervjustudie med induktiv ansats. Semistrukturerade intervjuer genomfördes med tio sjuksköterskor verksamma inom hjärtsjukvård. Insamlade data transkriberades och analyserades med inspiration från Graneheim och Lundmans kvalitativa innehållsanalys.   Resultatet genererade i de fem kategorierna: sjuksköterskornas erfarenheter av insjuknandet i TS, sjuksköterskornas erfarenheter av omvårdnadsbehovet vid TS, sjuksköterskornas erfarenheter av omvårdnadsåtgärder vid TS, kunskap och evidens i omvårdnadsarbetet vid TS och sjuksköterskans copingstrategier vid bristande evidens och kunskap. Sjuksköterskorna hade varierande erfarenheter av omvårdnaden och de flesta tyckte att omvårdnadsarbetet vid TS var svårt. Många av sjuksköterskorna upplevde svårigheter att besvara patienternas frågor och att detta påverkades av begränsad kunskap inom området och av att det inte fanns några riktlinjer att följa för omvårdnadsarbetet. Detta gjorde att sjuksköterskorna inte visste om det fanns några särskilda restriktioner och rekommendationer för dessa patienter. Sjuksköterskorna upplevde även att patienterna var i stort behov av samtal och information och att en stor del av omvårdnadsarbetet bestod av att försöka tillgodose detta behov.   Slutsatsen i denna studie är att sjuksköterskorna upplevde att det saknades kunskap om specifik omvårdnad vid TS. De ville erbjuda patienterna bästa möjliga omvårdnad och de efterfrågade mer kunskap och stöd för att kunna åstadkomma detta. Sjuksköterskorna upplevde frustration eftersom de inte kunde erbjuda evidensbaserad omvårdnad till dessa patienter på samma sätt de vanligtvis kunde erbjuda till andra patienter. Den omvårdnad som erbjöds till patienterna varierade mellan sjuksköterskorna och nedprioriterades ofta, bland annat till fördel för det medicinska arbetet och för andra patienter i större behov av omvårdnad. / About two percent of the patients who suffer from symptoms consistent with acute coronary syndrome (ACS) have instead been affected by takotsubo syndrome (TS). TS is considered to be severely under-diagnosed and also often incorrectly diagnosed. Deficiencies in recommendations and lack of guidelines, in combination with the fact that patients are not particularly common, can affect the prerequisites nurses have to offer these patients evidence-based and person-centered care.   The purpose of the study was to describe nurses' experiences of nursing care in takotsubo syndrome.   The method was a qualitative, descriptive interview study with inductive approach. Semi-structured interviews were conducted with ten practicing nurses in heart care. The collected data was transcribed and analyzed with inspiration from Graneheim and Lundman's qualitative content analysis.   The results generated five categories: nurses´ experiences of suffering from TS, nurses’ experiences of nursing care, nurses’ experiences of nursing actions, knowledge and evidence in nursing care and nurses´ coping strategies in case of lack of evidence and knowledge. The nurses had different experiences with the nursing care, and a majority expressed difficulties nursing patients with TS. Many nurses experienced difficulties in answering the patients' questions and that this was affected by limited knowledge as well as there were no specific guidelines for the appropriate nursing care. This meant that the nurses did not know if there were any particular restrictions and recommendations for these patients. Furthermore, the nurses expressed the need for patients being given proper support and information.   The conclusion of this study is that the nurses experienced lack of knowledge in specific nursing care of patients with TS. The nurses wanted to offer the best possible care and they asked for more knowledge and support in order to achieve this. Due to lack of support and information the nurses felt frustrated as they were unable to offer evidence-based nursing equal to that of any other patient. The results also showed that the nursing care offered to the patients varied between the nurses and that the nursing care of the patients with TS to a large extent was given less priority. This down-prioritization was to the benefit of the medical work and other patients who were deemed to be in greater need of nursing care. The discrimination of TS patients was largely to prioritize other patients in greater need of nursing care.   About two percent of the patients who suffer from symptoms consistent with acute coronary syndrome (ACS) have instead been affected by takotsubo syndrome (TS). TS is considered to be severely under-diagnosed and also often incorrectly diagnosed. Deficiencies in recommendations and lack of guidelines, in combination with the fact that patients are not particularly common, can affect the prerequisites nurses have to offer these patients evidence-based and person-centered care.   The purpose of the study was to describe nurses' experiences of nursing care in takotsubo syndrome.   The method was a qualitative, descriptive interview study with inductive approach. Semi-structured interviews were conducted with ten practicing nurses in heart care. The collected data was transcribed and analyzed with inspiration from Graneheim and Lundman's qualitative content analysis.   The results generated five categories: nurses´ experiences of suffering from TS, nurses’ experiences of nursing care, nurses’ experiences of nursing actions, knowledge and evidence in nursing care and nurses´ coping strategies in case of lack of evidence and knowledge. The nurses had different experiences with the nursing care, and a majority expressed difficulties nursing patients with TS. Many nurses experienced difficulties in answering the patients' questions and that this was affected by limited knowledge as well as there were no specific guidelines for the appropriate nursing care. This meant that the nurses did not know if there were any particular restrictions and recommendations for these patients. Furthermore, the nurses expressed the need for patients being given proper support and information.   The conclusion of this study is that the nurses experienced lack of knowledge in specific nursing care of patients with TS. The nurses wanted to offer the best possible care and they asked for more knowledge and support in order to achieve this. Due to lack of support and information the nurses felt frustrated as they were unable to offer evidence-based nursing equal to that of any other patient. The results also showed that the nursing care offered to the patients varied between the nurses and that the nursing care of the patients with TS to a large extent was given less priority. This down-prioritization was to the benefit of the medical work and other patients who were deemed to be in greater need of nursing care. The discrimination of TS patients was largely to prioritize other patients in greater need of nursing care.

Cardiac magnetic resonance (CMR)-derived left ventricular (LV) global longitudinal strain (GLS) provides incremental prognostic information on various cardiovascular diseases but has not yet been investigated comprehensively in patients with Takotsubo syndrome (TS). This study evaluated the prognostic value of feature tracking (FT) GLS, tissue tracking (TT) GLS, and fast manual long axis strain (LAS) in 147 patients with TS, who underwent CMR at a median of 2 days after admission. Long-term mortality was assessed 3 years after the acute event. In contrast to LV ejection fraction and tissue characteristics, impaired FT-GLS, TT-GLS and fast manual LAS were associated with adverse outcome. The best cutoff points for the prediction of long-term mortality were similar with all three approaches: FT-GLS −11.28%, TT-GLS −11.45%, and fast manual LAS −10.86%. Long-term mortality rates were significantly higher in patients with FT-GLS > −11.28% (25.0% versus 9.8%; p = 0.029), TT-GLS > −11.45% (20.0% versus 5.4%; p = 0.016), and LAS > −10.86% (23.3% versus 6.6%; p = 0.014). However, in multivariable analysis, diabetes mellitus (p = 0.001), atrial fibrillation (p = 0.001), malignancy (p = 0.006), and physical triggers (p = 0.006) outperformed measures of myocardial strain and emerged as the strongest, independent predictors of long-term mortality in TS. In conclusion, CMR-based longitudinal strain provides valuable prognostic information in patients with TS, regardless of the utilized technique of assessment. Long-term mortality, however, is mainly determined by comorbidities.