Stress cardiomyopathy

Stress cardiomyopathy
Schematic representation of Takotsubo cardiomyopathy (A) compared to the situation in a normal person (B).
ICD-9	429.83
DiseasesDB	33976
MeSH	054549

Stress cardiomyopathy Microchapters
Home
Overview
Historical Perspective
Classification
Pathophysiology
Causes
Differentiating Stress Cardiomyopathy from other Diseases
Epidemiology and Demographics
Risk Factors
Screening
Natural History, Complications and Prognosis
Diagnosis
Diagnostic Criteria
History and Symptoms
Physical Examination
Laboratory Findings
Electrocardiogram
Chest X Ray
CT
MRI
Echocardiography
Other Imaging Findings
Other Diagnostic Studies
Treatment
Medical Therapy
Surgery
Primary Prevention
Secondary Prevention
Cost-Effectiveness of Therapy
Unstable angina/non ST elevation myocardial infarction in Stress (Takotsubo) Cardiomyopathy
Future or Investigational Therapies
Case Studies
Case #1
Stress cardiomyopathy On the Web
Most recent articles
Most cited articles
Review articles
CME Programs
Powerpoint slides
Images
American Roentgen Ray Society Images of Stress cardiomyopathy All Images X-rays Echo & Ultrasound CT Images MRI
Ongoing Trials at Clinical Trials.gov
US National Guidelines Clearinghouse
NICE Guidance
FDA on Stress cardiomyopathy
CDC on Stress cardiomyopathy
Stress cardiomyopathy in the news
Blogs on Stress cardiomyopathy
Directions to Hospitals Treating Stress cardiomyopathy
Risk calculators and risk factors for Stress cardiomyopathy

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Synonyms and keywords: Takotsubo cardiomyopathy; Tako-tsubo syndrome; Left Ventricular Apical Ballooning Syndrome; Ampulla-Shaped Cardiomyopathy; Broken Heart Syndrome; transient apical dysfunction

Overview

Stress cardiomyopathy is a cardiac syndrome characterized by a reversible transient apical ventricular dysfunction.

Diagnosis

Mayo Criteria

Mayo Clinic Criteria for Apical Ballooning Syndrome. All 4 must be present :

1. Transient hypokinesis, akinesis or dyskinesis of the left ventricular mid-segments with or without apical involvement. The regional wall motion abnormalities extend beyond a single epicardial vascular distribution. A stressful trigger is often, but not always present
2. Absence of obstructive coronary disease or angiographic evidence of acute plaque rupture.
3. New electrocardiographic abnormalities (either ST-segment elevation and/or T- wave inversion) or modest elevation in cardiac troponin.
4. Absence of pheochromocytoma and myocarditis

Treatment

The treatment of stress cardiomyopathy is supportive as the condition is reversible. Initial treatment should be similar to that of an acute coronary syndrome with therapy directed at relieving myocardial ischemia with administration of aspirin, intravenous heparin and beta blockers. Once a diagnosis of stress cardiomyopathy has been confirmed and an acute coronary syndrome excluded, consideration should be given to continuing beta-blocker therapy empirically since catecholamines are suspected of contributing to the syndrome. Diuretics are effective for the treatment of congestive heart failure. Angiotensin converting enzyme inhibitors may be used if the diagnosis is uncertain, until there is complete recovery of systolic function. Insofar as the left ventricular function and apical wall motion return to normal within days or weeks, long-term anti-coagulation does not appear to be necessary.