Stress cardiomyopathy other diagnostic studies: Difference between revisions
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===Coronary Angiography=== | ===Coronary Angiography=== | ||
Stress cardiomyopathy can mimic an [[acute MI]], mainly [[anterior MI]], since the clinical presentation, [[ECG]] and laboratory findings are similar. Hence, [[coronary angiography]] is considered a great diagnostic modality to differentiate between the two diagnoses. A normal [[angiography]] or absence of substantial [[coronary]] [[stenosis]] supports the diagnosis of stress cardiomyopathy.<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> | Stress cardiomyopathy can mimic an [[acute MI]], mainly [[anterior MI]], since the clinical presentation, [[ECG]] and laboratory findings are similar. Hence, [[coronary angiography]] is considered a great diagnostic modality to differentiate between the two diagnoses. A normal [[angiography]] or absence of substantial [[coronary]] [[stenosis]] supports the diagnosis of stress cardiomyopathy.<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> | ||
===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> | |||
*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=== | ||
Revision as of 22:40, 6 January 2017
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Stress cardiomyopathy Microchapters |
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Unstable angina/non ST elevation myocardial infarction in Stress (Takotsubo) Cardiomyopathy |
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Stress cardiomyopathy other diagnostic studies On the Web |
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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]
Overview
Other Diagnostic Studies
Coronary Angiography
Stress cardiomyopathy can mimic an acute MI, mainly anterior MI, since the clinical presentation, ECG and laboratory findings are similar. Hence, coronary angiography is considered a great diagnostic modality to differentiate between the two diagnoses. A normal angiography or absence of substantial coronary stenosis supports the diagnosis of stress cardiomyopathy.[1]
Cardiac Catheterization
When patients with stress cardiomyopathy undergo cardiac catheterization, the following findings are usually reported:[2]
- 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:[1][2]
- 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.[1]
References
- ↑ 1.0 1.1 1.2 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.
- ↑ 2.0 2.1 Brenner ZR, Powers J (2008). "Takotsubo cardiomyopathy". Heart Lung. 37 (1): 1–7. doi:10.1016/j.hrtlng.2006.12.003. PMID 18206521.