Stress cardiomyopathy natural history, complications and prognosis
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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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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Dima Nimri, M.D. [2]
Overview
Natural History
Provided that patients survive the initial insult without any complications, most patients recover and have a normalized cardiac function within a few weeks.[1][2][3]
Complications
Complications of stress cardiomyopathy include:[1][4][5][3][6]
- Heart failure
- Pulmonary edema
- Cardiogenic shock
- Bradycardia
- Arrythmias, mainly QT prolongation and ventricular arrhythmias
- Left ventricular mural thrombus
- Mitral valve dysfunction pulmonary embolism
- Mitral regurgitation
- LV free wall rupture
- Heart rupture
- Death
Prognosis
The prognosis of stress cardiomyopathy is generally good, even without medical therapy.[5][3] Most patients have a restored cardiac function within a few weeks.[2][3] However, fatal complications such as LV free wall rupture and heart rupture may occur and mortality rate in patients with stress cardiomyopathy ranges from 0-8%.[1][5]
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 Prasad A, Lerman A, Rihal CS (2008). "Apical ballooning syndrome (Tako-Tsubo or stress cardiomyopathy): a mimic of acute myocardial infarction". Am. Heart J. 155 (3): 408–17. doi:10.1016/j.ahj.2007.11.008. PMID 18294473.
- ↑ 3.0 3.1 3.2 3.3 Tsai TT, Nallamothu BK, Prasad A, Saint S, Bates ER (2009). "Clinical problem-solving. A change of heart". N. Engl. J. Med. 361 (10): 1010–6. doi:10.1056/NEJMcps0903023. PMID 19726776.
- ↑ Omerovic E (2011). "How to think about stress-induced cardiomyopathy?--Think "out of the box"!". Scand. Cardiovasc. J. 45 (2): 67–71. doi:10.3109/14017431.2011.565794. PMID 21401402.
- ↑ 5.0 5.1 5.2 Brenner ZR, Powers J (2008). "Takotsubo cardiomyopathy". Heart Lung. 37 (1): 1–7. doi:10.1016/j.hrtlng.2006.12.003. PMID 18206521.
- ↑ Efferth T, Banerjee M, Paul NW (2016). "Broken heart, tako-tsubo or stress cardiomyopathy? Metaphors, meanings and their medical impact". Int. J. Cardiol. doi:10.1016/j.ijcard.2016.12.129. PMID 28041712.