COVID-19-associated stress cardiomyopathy differential diagnosis: Difference between revisions
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Revision as of 20:41, 18 July 2020
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: José Eduardo Riceto Loyola Junior, M.D.[2]
Overview
COVID-19-associated stress cardiomyopathy must be differentiated from other diseases that cause left ventricular dysfunction such as acute myocardial infarction (STEMI and NSTEMI) and viral myocarditis.
Differential Diagnosis
- COVID-19-associated stress cardiomyopathy must be differentiated from other diseases that cause left ventricular dysfunction such as acute myocardial infarction (STEMI and NSTEMI) and viral myocarditis.
| Disease | Can Present With | Cardiac Enzymes | Catecholamine Levels | ECG Findings | Echocardiography Findings | Prognosis |
|---|---|---|---|---|---|---|
| Stress Cardiomyopathy | Chest pain, dyspnea | ↑ | Transiently elevated | ST elevation in precordial leads | LV regional dysfunction | Very good |
| Pheochromocytoma | Chest pain, dyspnea | Can be positive | Persistently elevated | ST elevation in precordial leads | LV regional dysfunction | Good to poor - it varies if disease is localized or diffuse (95% to 50% survival in 5 years)[1] |
| Anterior MI | Chest pain, dyspnea | ↑↑↑ | - | ST elevation in precordial leads | Dysfunction at area of infarction | Variable - depends on the coronary lesion, but usually it has a 30% mortality rate and 5-10% of the survivors die within one year of the event[2] |
| Myocarditis | Chest pain, dyspnea, fever | May be acutely elevated | - | May show atrial fibrillation, LBBB or AV block | Diffuse hypokinesia | Extremely variable |
| Dilated Cardiomyopathy | Dyspnea, dyspnea on exertion, cough, edema, fatigue | Usually negative | - | May show atrial fibrillation, LBBB or AV block | LV enlargement | Poor - survival is less than 50% in ten years[3] |
| Hypertrophic Cardiomyopathy | Chest pain, dyspnea, syncope, sudden cardiac death | Usually negative | - | Common findings include: | LV hypertrophy, systolic anterior motion of the mitral valve, asymmetric septal hypertrophy | Generably good with up to 2/3 of the patients having a normal life, and a 1% cardiac annual mortality[4] |
| COVID-19-associated Stress Cardiomyopathy | Chest pain, dyspnea | ↑ | Transiently elevated | ST elevation in precordial leads | LV regional dysfunction | Very good - but hospitalizations may be longer in comparison to regular stress cardiomyopathy[5] |
References
- ↑ "Cancer.net - Statistics of Pheochromocytoma and Paraganglioma". Cancer.net. 07/18/2020. Check date values in:
|date=(help) - ↑ "Medscape - Acute MI". Medscape. 07/18/2020. Check date values in:
|date=(help) - ↑ "Medscape - Dilated Cardiomyopathy". Medscape. 07/18/2020. Check date values in:
|date=(help) - ↑ Ten Cate FJ (1996). "Prognosis of hypertrophic cardiomyopathy". J Insur Med. 28 (1): 42–5. PMID 10163618.
- ↑ Invalid
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