Transient left ventricular dysfunction due to stress-induced cardiomyopathy.
The case presented here is of a 71-yr-old female patient who met the diagnostic criteria for stress-induced cardiomyopathy, which was triggered by intense emotional stress after being hit by a bicycle. The clinical picture mimicked that of an acute myocardial infarction, manifesting as precordial pain, ST-segment depression followed by deep negative T waves and prolonging of the QT interval, slight increase in cardiac enzymes and coursing with transient apical ballooning of the left ventricle and hyperkinesis of the basal walls (conferring the aspect of "apical ballooning"), although in the absence of subepicardial coronary obstruction. Ventricular function normalized after the second week of clinical evolution.
Simões
Marcus Vinicius
MV
Divisão de Cardiologia, Hospital das Clínicas, Faculdade de Medicina de Ribeirão Preto, USP, Ribeirão Preto, SP, Brasil. simoesmv@yahoo.com
Marin-Neto
José Antonio
JA
Romano
Minna Moreira Dias
MM
O'Connell
João Lucas
JL
de Santi
Giovani Luis
GL
Maciel
Benedito Carlos
BC
D054058:Acute Coronary Syndrome / Q000523:psychology; D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use; D000368:Aged; D047228:Angiotensin II Type 1 Receptor Blockers / Q000627:therapeutic use; D009202:Cardiomyopathies / Q000523:psychology*; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D019808:Losartan / Q000627:therapeutic use; D008790:Metoprolol / Q000627:therapeutic use; D013315:Stress, Psychological / Q000523:psychology*; D018487:Ventricular Dysfunction, Left / Q000175:diagnosis / Q000188:drug therapy / Q000523:psychology*
D000319:Adrenergic beta-Antagonists; D047228:Angiotensin II Type 1 Receptor Blockers; D008790:Metoprolol; D019808:Losartan