Stress cardiomyopathy differential diagnosis: Difference between revisions
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{{CMG}}; {{AE}}{{DN}} | {{CMG}}; {{AE}}{{DN}} | ||
==Overview== | ==Overview== | ||
The clinical presentation, laboratory findings and imaging studies of stress cardiomyopathy resembles that of [[anterior MI]] and must be differentiated from it. Also, stress cardiomyopathy must be differentiated from Takotsubo-like cardiomyopathy, such as that due to [[pheochromocytoma]]. | The clinical presentation, laboratory findings and imaging studies of stress cardiomyopathy resembles that of [[anterior MI]] and must be differentiated from it. Also, stress cardiomyopathy must be differentiated from Takotsubo-like cardiomyopathy, such as that due to [[pheochromocytoma]]. | ||
== Differentiating Stress Cardiomyopathy from other Diseases == | == Differentiating Stress Cardiomyopathy from other Diseases == | ||
The presentation of stress cardiomyopathy mimics that of [[Anterior myocardial infarction|anterior wall MI]] and must be differentiated from it:<ref name="pmid17223415">{{cite journal |vauthors=Parodi G, Del Pace S, Carrabba N, Salvadori C, Memisha G, Simonetti I, Antoniucci D, Gensini GF |title=Incidence, clinical findings, and outcome of women with left ventricular apical ballooning syndrome |journal=Am. J. Cardiol. |volume=99 |issue=2 |pages=182–5 |year=2007 |pmid=17223415 |doi=10.1016/j.amjcard.2006.07.080 |url=}}</ref> | The presentation of stress cardiomyopathy mimics that of [[Anterior myocardial infarction|anterior wall MI]] and must be differentiated from it. However, other medical conditions that must also be differentiated from stress cardiomyopathy include:<ref name="pmid17223415">{{cite journal |vauthors=Parodi G, Del Pace S, Carrabba N, Salvadori C, Memisha G, Simonetti I, Antoniucci D, Gensini GF |title=Incidence, clinical findings, and outcome of women with left ventricular apical ballooning syndrome |journal=Am. J. Cardiol. |volume=99 |issue=2 |pages=182–5 |year=2007 |pmid=17223415 |doi=10.1016/j.amjcard.2006.07.080 |url=}}</ref><ref name="pmid23058349">{{cite journal |vauthors=Mikail N, Hess S, Jesel L, El Ghannudi S, El Husseini Z, Trinh A, Ohlmann P, Morel O, Imperiale A |title=Takotsubo and Takotsubo-like syndrome: a common neurogenic myocardial stunning pathway? |journal=Int. J. Cardiol. |volume=166 |issue=1 |pages=248–50 |year=2013 |pmid=23058349 |doi=10.1016/j.ijcard.2012.09.116 |url=}}</ref> | ||
{| class="wikitable" | {| class="wikitable" | ||
! | !Disease | ||
! | !Can Present With | ||
! | !Cardiac Enzymes | ||
!Catecholamine Levels | |||
!ECG Findings | |||
!Echocardiography Findings | |||
|- | |- | ||
|[[Chest pain]] | |Stress Cardiomyopathy | ||
| | |[[Chest pain]], [[dyspnea]] | ||
| | |↑ | ||
|Transiently elevated | |||
|[[ST elevation]] in [[precordial leads]] | |||
|[[LV]] regional dysfunction | |||
|- | |- | ||
|[[Pheochromocytoma]] | |||
|[[Chest pain]], [[dyspnea]] | |||
|Can be positive | |||
|Persistently elevated | |||
|[[ST elevation]] in [[precordial leads]] | |[[ST elevation]] in [[precordial leads]] | ||
| | |[[LV]] regional dysfunction | ||
|- | |- | ||
| | |[[Anterior MI]] | ||
| | |[[Chest pain]], [[dyspnea]] | ||
|↑↑↑ | |↑↑↑ | ||
|N/A | |||
|[[ST elevation]] in [[precordial leads]] | |||
|Dysfunction at area of [[infarction]] | |||
|- | |- | ||
| | |[[Myocarditis]] | ||
| | |[[Chest pain]], [[dyspnea]], [[fever]] | ||
|May be acutely elevated | |||
|N/A | |||
|May show [[atrial fibrillation]], [[Left bundle branch block|LBBB]] or [[AV block]] | |||
|Diffuse [[hypokinesia]] | |||
| | |||
|- | |- | ||
|[[ | |[[Dilated cardiomyopathy|Dilated Cardiomyopathy]] | ||
| | |[[Dyspnea]], [[dyspnea on exertion]], [[cough]], [[edema]], [[fatigue]] | ||
| | |Usually negative | ||
|N/A | |||
|May show [[atrial fibrillation]], [[Left bundle branch block|LBBB]] or [[AV block]] | |||
|[[LV]] enlargement | |||
|- | |- | ||
|[[ | |[[Hypertrophic Cardiomyopathy]] | ||
|[[Chest pain]], [[dyspnea]], [[syncope]], [[sudden cardiac death]] | |||
|Usually negative | |||
|N/A | |||
|Common findings include: | |||
| | * [[Right axis deviation|Right]] or [[left axis deviation]] | ||
| | * [[Bundle branch block|BBB]] | ||
| | * [[Sinus bradycardia]] | ||
|[[ | |[[LV hypertrophy]], [[systolic]] anterior motion of the [[mitral valve]], asymmetric septal [[hypertrophy]] | ||
| | |||
|[[ | |||
|} | |} | ||
==References== | ==References== | ||
{{reflist|2}} | {{reflist|2}} | ||
{{WH}} | {{WH}} | ||
{{WS}} | {{WS}} | ||
Revision as of 20:34, 13 January 2017
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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 differential diagnosis On the Web |
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American Roentgen Ray Society Images of Stress cardiomyopathy differential diagnosis |
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Risk calculators and risk factors for Stress cardiomyopathy differential diagnosis |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Dima Nimri, M.D. [2]
Overview
The clinical presentation, laboratory findings and imaging studies of stress cardiomyopathy resembles that of anterior MI and must be differentiated from it. Also, stress cardiomyopathy must be differentiated from Takotsubo-like cardiomyopathy, such as that due to pheochromocytoma.
Differentiating Stress Cardiomyopathy from other Diseases
The presentation of stress cardiomyopathy mimics that of anterior wall MI and must be differentiated from it. However, other medical conditions that must also be differentiated from stress cardiomyopathy include:[1][2]
| Disease | Can Present With | Cardiac Enzymes | Catecholamine Levels | ECG Findings | Echocardiography Findings |
|---|---|---|---|---|---|
| Stress Cardiomyopathy | Chest pain, dyspnea | ↑ | Transiently elevated | ST elevation in precordial leads | LV regional dysfunction |
| Pheochromocytoma | Chest pain, dyspnea | Can be positive | Persistently elevated | ST elevation in precordial leads | LV regional dysfunction |
| Anterior MI | Chest pain, dyspnea | ↑↑↑ | N/A | ST elevation in precordial leads | Dysfunction at area of infarction |
| Myocarditis | Chest pain, dyspnea, fever | May be acutely elevated | N/A | May show atrial fibrillation, LBBB or AV block | Diffuse hypokinesia |
| Dilated Cardiomyopathy | Dyspnea, dyspnea on exertion, cough, edema, fatigue | Usually negative | N/A | May show atrial fibrillation, LBBB or AV block | LV enlargement |
| Hypertrophic Cardiomyopathy | Chest pain, dyspnea, syncope, sudden cardiac death | Usually negative | N/A | Common findings include: | LV hypertrophy, systolic anterior motion of the mitral valve, asymmetric septal hypertrophy |
References
- ↑ Parodi G, Del Pace S, Carrabba N, Salvadori C, Memisha G, Simonetti I, Antoniucci D, Gensini GF (2007). "Incidence, clinical findings, and outcome of women with left ventricular apical ballooning syndrome". Am. J. Cardiol. 99 (2): 182–5. doi:10.1016/j.amjcard.2006.07.080. PMID 17223415.
- ↑ Mikail N, Hess S, Jesel L, El Ghannudi S, El Husseini Z, Trinh A, Ohlmann P, Morel O, Imperiale A (2013). "Takotsubo and Takotsubo-like syndrome: a common neurogenic myocardial stunning pathway?". Int. J. Cardiol. 166 (1): 248–50. doi:10.1016/j.ijcard.2012.09.116. PMID 23058349.