Stress cardiomyopathy risk factors: Difference between revisions
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==Overview== | ==Overview== | ||
==Risk Factors== | ==Risk Factors== | ||
Often there is a history of a recent severe emotional or physical stress. | Often there is a history of a recent severe emotional or physical stress. Case series looking at large groups of patients report that some patients develop apical balloon syndrome after an emotional stressor, while others have a preceding clinical stressor (such as an [[asthma]] attack or sudden illness). Roughly one third of patients have no preceding stressful event <ref>{{cite journal |last=Elesber |first=AA |year=2007 |month=July |title=Four-Year Recurrence Rate and Prognosis of the Apical Ballooning Syndrome |journal=J Amer Coll Card |volume=50 |issue=5 |pages=448-52}}</ref>. The syndrome has been reported to occur after earthquakes, <ref name="pmid8615397">{{cite journal |author=Yamabe H, Hanaoka J, Funakoshi T, ''et al'' |title=Deep negative T waves and abnormal cardiac sympathetic image (123I-MIBG) after the Great Hanshin Earthquake of 1995 |journal=Am. J. Med. Sci. |volume=311 |issue=5 |pages=221–4 |year=1996 |pmid=8615397 |doi=}}</ref> after non-cardiac surgery, <ref name="pmid17184686">{{cite journal |author=Berman M, Saute M, Porat E, ''et al'' |title=Takotsubo cardiomyopathy: expanding the differential diagnosis in cardiothoracic surgery |journal=Ann. Thorac. Surg. |volume=83 |issue=1 |pages=295–8 |year=2007 |pmid=17184686 |doi=10.1016/j.athoracsur.2006.05.115}}</ref> and in patients with noncardiac medical emergencies. <ref name="pmid11796564">{{cite journal |author=Akashi YJ, Sakakibara M, Miyake F |title=Reversible left ventricular dysfunction "takotsubo" cardiomyopathy associated with pneumothorax |journal=Heart |volume=87 |issue=2 |pages=E1 |year=2002 |pmid=11796564 |doi=}}</ref> | ||
Although it had been previously reported that an identifiable stressful event occurred in most patients (90%) prior to onset of stress cardiomyopathy, only 71% of patients in Eitel et al.’s study experienced a clearly identifiable emotional or physical trigger <ref>Eitel I, von Knobelsdorff-Brekenhoff F, Bernhardt P, et al. Clinical characteristics and CV magnetic resonance findings in stress (Takotsubo) cardiomyopathy. JAMA 2011; 306:277-286.</ref>. Thus, it cannot be assumed that all stress cardiomyopathy patients experience a common trigger, and a stress cardiomyopathy diagnosis cannot be discounted if a trigger is not present. | Although it had been previously reported that an identifiable stressful event occurred in most patients (90%) prior to onset of stress cardiomyopathy, only 71% of patients in Eitel et al.’s study experienced a clearly identifiable emotional or physical trigger <ref>Eitel I, von Knobelsdorff-Brekenhoff F, Bernhardt P, et al. Clinical characteristics and CV magnetic resonance findings in stress (Takotsubo) cardiomyopathy. JAMA 2011; 306:277-286.</ref>. Thus, it cannot be assumed that all stress cardiomyopathy patients experience a common trigger, and a stress cardiomyopathy diagnosis cannot be discounted if a trigger is not present. | ||
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Unstable angina/non ST elevation myocardial infarction in Stress (Takotsubo) Cardiomyopathy |
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
Risk Factors
Often there is a history of a recent severe emotional or physical stress. Case series looking at large groups of patients report that some patients develop apical balloon syndrome after an emotional stressor, while others have a preceding clinical stressor (such as an asthma attack or sudden illness). Roughly one third of patients have no preceding stressful event [1]. The syndrome has been reported to occur after earthquakes, [2] after non-cardiac surgery, [3] and in patients with noncardiac medical emergencies. [4]
Although it had been previously reported that an identifiable stressful event occurred in most patients (90%) prior to onset of stress cardiomyopathy, only 71% of patients in Eitel et al.’s study experienced a clearly identifiable emotional or physical trigger [5]. Thus, it cannot be assumed that all stress cardiomyopathy patients experience a common trigger, and a stress cardiomyopathy diagnosis cannot be discounted if a trigger is not present.
References
- ↑ Elesber, AA (2007). "Four-Year Recurrence Rate and Prognosis of the Apical Ballooning Syndrome". J Amer Coll Card. 50 (5): 448–52. Unknown parameter
|month=ignored (help) - ↑ Yamabe H, Hanaoka J, Funakoshi T; et al. (1996). "Deep negative T waves and abnormal cardiac sympathetic image (123I-MIBG) after the Great Hanshin Earthquake of 1995". Am. J. Med. Sci. 311 (5): 221–4. PMID 8615397.
- ↑ Berman M, Saute M, Porat E; et al. (2007). "Takotsubo cardiomyopathy: expanding the differential diagnosis in cardiothoracic surgery". Ann. Thorac. Surg. 83 (1): 295–8. doi:10.1016/j.athoracsur.2006.05.115. PMID 17184686.
- ↑ Akashi YJ, Sakakibara M, Miyake F (2002). "Reversible left ventricular dysfunction "takotsubo" cardiomyopathy associated with pneumothorax". Heart. 87 (2): E1. PMID 11796564.
- ↑ Eitel I, von Knobelsdorff-Brekenhoff F, Bernhardt P, et al. Clinical characteristics and CV magnetic resonance findings in stress (Takotsubo) cardiomyopathy. JAMA 2011; 306:277-286.