Stress cardiomyopathy criteria: Difference between revisions
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Mayo Clinic Criteria for Apical Ballooning Syndrome. All 4 must be present <ref name="pmid17283269">{{cite journal |author=Prasad A |title=Apical ballooning syndrome: an important differential diagnosis of acute myocardial infarction |journal=Circulation |volume=115 |issue=5 |pages=e56–9 |year=2007 |pmid=17283269 |doi=10.1161/CIRCULATIONAHA.106.669341}}</ref>: | Mayo Clinic Criteria for Apical Ballooning Syndrome. All 4 must be present <ref name="pmid17283269">{{cite journal |author=Prasad A |title=Apical ballooning syndrome: an important differential diagnosis of acute myocardial infarction |journal=Circulation |volume=115 |issue=5 |pages=e56–9 |year=2007 |pmid=17283269 |doi=10.1161/CIRCULATIONAHA.106.669341}}</ref>: | ||
* 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 | |||
* Absence of obstructive coronary disease or angiographic evidence of acute plaque rupture. | |||
* New electrocardiographic abnormalities (either ST-segment elevation and/or T- wave inversion) or modest elevation in cardiac [[troponin]]. | |||
* Absence of [[pheochromocytoma]] and [[myocarditis]] | |||
===The Various Patterns of Wall Motion Abnormalities=== | |||
It should be that the wall motion abnormalities are not always anteroapical. | |||
<div align="center"> | |||
<gallery heights="175" widths="175"> | |||
Image:Takotsubo Diagram.jpg|Different end-systolic left ventricular (LV) silhouettes. | |||
</gallery> | |||
</div> | |||
A, <ref>Abe Y, Kondo M, Matsuoka R, Araki M, Dohyama K, Tanio H. Assessment of clinical features in transient left ventricular apical ballooning. J Am Coll Cardiol. 2003;41:737-742.</ref>; B, <ref>San Roman Sanchez D, Medina O, Jimenez F, Rodriguez JC, Nieto V. Dynamic intraventricular obstruction in acute myocardial infarction. Echocardiography. 2001;18:515-518.</ref>; C, <ref>Wittstein IS, Thiemann DR, Lima JA, et al. Neurohumoral features of myocardial stunning due to sudden emotional stress. N Engl J Med. 2005;352:539-548.</ref>; D, <ref>Rivera JM, Locketz AJ, Fritz KD, et al. “Broken heart syndrome” after separation (from OxyContin). Mayo Clin Proc. 2006;81:825-828.</ref>; E, <ref>Desmet WJ, Adriaenssens BF, Dens JA. Apical ballooning of the left ventricle: first series in white patients. Heart. 2003;89:1027-1031.</ref>; and F, <ref>Reyburn AM, Vaglio JC Jr. Transient left ventricular apical ballooning syndrome. Mayo Clin Proc. 2006;81:824.</ref>. There is wide heterogeneity among the different patterns, varying from a relatively small akinetic apical area in C to a wide global akinesia in D and E. <ref>Ibanez B. Takotsubo Syndrome: A Bayesian Approach to Interpreting Its Pathogenesis Mayo Clin Proc. 2006; 81: 732-735</ref> | |||
==References== | ==References== |
Revision as of 06:22, 28 August 2012
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
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
- Absence of obstructive coronary disease or angiographic evidence of acute plaque rupture.
- New electrocardiographic abnormalities (either ST-segment elevation and/or T- wave inversion) or modest elevation in cardiac troponin.
- Absence of pheochromocytoma and myocarditis
The Various Patterns of Wall Motion Abnormalities
It should be that the wall motion abnormalities are not always anteroapical.
A, [2]; B, [3]; C, [4]; D, [5]; E, [6]; and F, [7]. There is wide heterogeneity among the different patterns, varying from a relatively small akinetic apical area in C to a wide global akinesia in D and E. [8]
References
- ↑ Prasad A (2007). "Apical ballooning syndrome: an important differential diagnosis of acute myocardial infarction". Circulation. 115 (5): e56–9. doi:10.1161/CIRCULATIONAHA.106.669341. PMID 17283269.
- ↑ Abe Y, Kondo M, Matsuoka R, Araki M, Dohyama K, Tanio H. Assessment of clinical features in transient left ventricular apical ballooning. J Am Coll Cardiol. 2003;41:737-742.
- ↑ San Roman Sanchez D, Medina O, Jimenez F, Rodriguez JC, Nieto V. Dynamic intraventricular obstruction in acute myocardial infarction. Echocardiography. 2001;18:515-518.
- ↑ Wittstein IS, Thiemann DR, Lima JA, et al. Neurohumoral features of myocardial stunning due to sudden emotional stress. N Engl J Med. 2005;352:539-548.
- ↑ Rivera JM, Locketz AJ, Fritz KD, et al. “Broken heart syndrome” after separation (from OxyContin). Mayo Clin Proc. 2006;81:825-828.
- ↑ Desmet WJ, Adriaenssens BF, Dens JA. Apical ballooning of the left ventricle: first series in white patients. Heart. 2003;89:1027-1031.
- ↑ Reyburn AM, Vaglio JC Jr. Transient left ventricular apical ballooning syndrome. Mayo Clin Proc. 2006;81:824.
- ↑ Ibanez B. Takotsubo Syndrome: A Bayesian Approach to Interpreting Its Pathogenesis Mayo Clin Proc. 2006; 81: 732-735