Diverse clinical spectrum of stress-induced cardiomyopathy.
Stress-induced cardiomyopathy or Takotsubo cardiomyopathy is an uncommon disorder characterized by apical ballooning. The etiology and pathophysiology of this syndrome has not been fully evaluated. This case series examined the clinical characteristics and outcomes of 10 patients with confirmed stress-induced cardiomyopathy. We identified 10 cases of stress-induced cardiomyopathy. All exhibit characteristic apical ballooning and basal hyperkinesia except one with an "inverted Takotsubo" pattern. Coronary angiography excluded coronary artery stenoses as a cause of cardiomyopathy. Patient characteristics, cardiac function, follow-up echocardiography and outcomes were determined. 60% of cases were female and 70% of cases had ST-segment elevations. Identified precipitants included severe emotional stress, subarachnoid haemorrhage and sepsis. None of the cases had angiographically significant coronary stenosis. One patient had an "inverted Takotsubo" pattern with mid-ventricular ballooning. Stress-induced cardiomyopathy is a clinical spectrum which can present with a classical "Takotsubo" or "inverted Takotsubo" pattern. Presentation is varied but characterized by recovery to normal cardiac systolic function. Study of this syndrome may enhance further understanding of the "brain-heart" relationship.
Lee
Yian-Ping
YP
Poh
Kian-Keong
KK
Lee
Chi-Hang
CH
Tan
Huay-Cheem
HC
Razak
Abdul
A
Chia
Boon-Lock
BL
Low
Adrian F
AF
D000328:Adult; D000368:Aged; D004562:Electrocardiography; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D013312:Stress, Physiological; D013315:Stress, Psychological / Q000150:complications*; D054549:Takotsubo Cardiomyopathy / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology*