Sandbox:DN

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: Right or left axis deviation BBB Sinus bradycardia	LV hypertrophy, systolic anterior motion of the mitral valve, asymmetric septal hypertrophy

	Stress Cardiomyopathy	Anterior Wall MI
Chest pain and dyspnea as presenting symptoms	✔	✔
ST elevation in precordial leads	✔	✔
Peak CK-MB value	<50 U/L	↑↑↑
6-month outcome	Favorable outcome	Higher rates of: Death Cardiac death Reinfarction Rehospitalization Major cardiac events

Stress cardiomyopathy must also be differentiated from Takotsubo-like syndrome caused by medical conditions, such as pheochromocytoma:

	Stress Cardiomyopathy	Takotsobu-like Syndrome
Chest pain mimicking MI	✔	✔
EKG findings (ST elevation)	✔	✔
Positive cardiac enzymes	✔	✔
LV regional dysfunction	✔	✔
Patient profile	Post-menopausal women	Younger patients with less female predominance
Catecholamine levels	Transient elevation	Constantly elevated
Complications		Higher rate of complications, including: Cardiogenic shock Heart failure Low ejection fraction (EF)