Stress cardiomyopathy other diagnostic studies: Difference between revisions
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__NOTOC__ | __NOTOC__ | ||
{{Stress cardiomyopathy}} | {{Stress cardiomyopathy}} | ||
{{CMG}} | {{CMG}}; {{AE}}{{DN}} | ||
==Overview== | ==Overview== | ||
[[Coronary angiography]] and [[cardiac catheterization]] are the diagnostic modalities of choice to distinguish between stress cardiomyopathy and acute [[anterior MI]]. Normal [[anatomy]] of the [[coronary arteries]], along with a reduced [[ejection fraction]] supports the diagnosis of stress cardiomyopathy. | |||
==Other Diagnostic Studies== | ==Other Diagnostic Studies== | ||
=== | ===Cardiac Catheterization=== | ||
When patients with stress cardiomyopathy undergo [[cardiac catheterization]], the following findings are usually reported:<ref name="pmid18206521">{{cite journal |vauthors=Brenner ZR, Powers J |title=Takotsubo cardiomyopathy |journal=Heart Lung |volume=37 |issue=1 |pages=1–7 |year=2008 |pmid=18206521 |doi=10.1016/j.hrtlng.2006.12.003 |url=}}</ref><ref name="pmid19726776">{{cite journal |vauthors=Tsai TT, Nallamothu BK, Prasad A, Saint S, Bates ER |title=Clinical problem-solving. A change of heart |journal=N. Engl. J. Med. |volume=361 |issue=10 |pages=1010–6 |year=2009 |pmid=19726776 |doi=10.1056/NEJMcps0903023 |url=}}</ref><ref name="pmid15276100">{{cite journal |vauthors=Bybee KA, Prasad A, Barsness GW, Lerman A, Jaffe AS, Murphy JG, Wright RS, Rihal CS |title=Clinical characteristics and thrombolysis in myocardial infarction frame counts in women with transient left ventricular apical ballooning syndrome |journal=Am. J. Cardiol. |volume=94 |issue=3 |pages=343–6 |year=2004 |pmid=15276100 |doi=10.1016/j.amjcard.2004.04.030 |url=}}</ref> | |||
*Normal [[anatomy]] of the [[coronary arteries]], without evidence of [[acute]] [[plaque rupture]] | |||
*Low [[ejection fraction|ejection fraction (EF)]] | |||
*Minimal or no evidence of [[coronary vasospasm]] | |||
*Minimal disturbance of [[microcirculation]] | |||
===Myocardial Biopsy=== | ===Myocardial Biopsy=== | ||
* Myocardial biopsy, although not necessary for diagnosis, can distinguish between stress cardiomyopathy and [[MI]]. | |||
* The histological findings on myocardial biopsy in patients with stress cardiomyopathy include:<ref name="pmid19106400">{{cite journal |vauthors=Akashi YJ, Goldstein DS, Barbaro G, Ueyama T |title=Takotsubo cardiomyopathy: a new form of acute, reversible heart failure |journal=Circulation |volume=118 |issue=25 |pages=2754–62 |year=2008 |pmid=19106400 |pmc=4893309 |doi=10.1161/CIRCULATIONAHA.108.767012 |url=}}</ref><ref name="pmid18206521">{{cite journal |vauthors=Brenner ZR, Powers J |title=Takotsubo cardiomyopathy |journal=Heart Lung |volume=37 |issue=1 |pages=1–7 |year=2008 |pmid=18206521 |doi=10.1016/j.hrtlng.2006.12.003 |url=}}</ref> | |||
:*[[Inflammatory]] infiltrates, consisting of [[mononuclear lymphocytes]], [[leukocytes]] and [[macrophages]] | |||
:*[[Myocardial]] [[fibrosis]] | |||
:*Contraction bands, which may or may not be associated with [[necrosis]]<br> | |||
*The combination of inflammatory changes and contraction bands distinguish stress cardiomyopathy from [[coagulative necrosis]] seen in [[MI]].<ref name="pmid19106400">{{cite journal |vauthors=Akashi YJ, Goldstein DS, Barbaro G, Ueyama T |title=Takotsubo cardiomyopathy: a new form of acute, reversible heart failure |journal=Circulation |volume=118 |issue=25 |pages=2754–62 |year=2008 |pmid=19106400 |pmc=4893309 |doi=10.1161/CIRCULATIONAHA.108.767012 |url=}}</ref> | |||
==References== | ==References== | ||
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Latest revision as of 20:33, 1 February 2019
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Stress cardiomyopathy Microchapters |
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Diagnosis |
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Treatment |
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Unstable angina/non ST elevation myocardial infarction in Stress (Takotsubo) Cardiomyopathy |
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Case Studies |
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Stress cardiomyopathy other diagnostic studies On the Web |
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American Roentgen Ray Society Images of Stress cardiomyopathy other diagnostic studies |
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Risk calculators and risk factors for Stress cardiomyopathy other diagnostic studies |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Dima Nimri, M.D. [2]
Overview
Coronary angiography and cardiac catheterization are the diagnostic modalities of choice to distinguish between stress cardiomyopathy and acute anterior MI. Normal anatomy of the coronary arteries, along with a reduced ejection fraction supports the diagnosis of stress cardiomyopathy.
Other Diagnostic Studies
Cardiac Catheterization
When patients with stress cardiomyopathy undergo cardiac catheterization, the following findings are usually reported:[1][2][3]
- Normal anatomy of the coronary arteries, without evidence of acute plaque rupture
- Low ejection fraction (EF)
- Minimal or no evidence of coronary vasospasm
- Minimal disturbance of microcirculation
Myocardial Biopsy
- Myocardial biopsy, although not necessary for diagnosis, can distinguish between stress cardiomyopathy and MI.
- The histological findings on myocardial biopsy in patients with stress cardiomyopathy include:[4][1]
- Inflammatory infiltrates, consisting of mononuclear lymphocytes, leukocytes and macrophages
- Myocardial fibrosis
- Contraction bands, which may or may not be associated with necrosis
- The combination of inflammatory changes and contraction bands distinguish stress cardiomyopathy from coagulative necrosis seen in MI.[4]
References
- ↑ 1.0 1.1 Brenner ZR, Powers J (2008). "Takotsubo cardiomyopathy". Heart Lung. 37 (1): 1–7. doi:10.1016/j.hrtlng.2006.12.003. PMID 18206521.
- ↑ Tsai TT, Nallamothu BK, Prasad A, Saint S, Bates ER (2009). "Clinical problem-solving. A change of heart". N. Engl. J. Med. 361 (10): 1010–6. doi:10.1056/NEJMcps0903023. PMID 19726776.
- ↑ Bybee KA, Prasad A, Barsness GW, Lerman A, Jaffe AS, Murphy JG, Wright RS, Rihal CS (2004). "Clinical characteristics and thrombolysis in myocardial infarction frame counts in women with transient left ventricular apical ballooning syndrome". Am. J. Cardiol. 94 (3): 343–6. doi:10.1016/j.amjcard.2004.04.030. PMID 15276100.
- ↑ 4.0 4.1 Akashi YJ, Goldstein DS, Barbaro G, Ueyama T (2008). "Takotsubo cardiomyopathy: a new form of acute, reversible heart failure". Circulation. 118 (25): 2754–62. doi:10.1161/CIRCULATIONAHA.108.767012. PMC 4893309. PMID 19106400.