Can quantitative regional myocardial dynamics contribute to the differential diagnosis of acute stress cardiomyopathy?
Acute stress-induced cardiomyopathy has excessive sympathetic stimulation, microvascular dysfunction similar to hypertension. Regional prominence of left ventricular (LV) septal base and stress-induced LV hypercontractility are the particular features of both acute and chronic stress-related conditions. Novel imaging methods have shown that stress-induced cavity dilation and myocardial wall abnormalities can be a reflection of underlying previous exaggerated hypertensive episodes due to sympathetic overdrive, which results in microvascular dysfunction. Hypertension-mediated chronic stress due to increased after load episodes is possibly the main reason for blunted LV myocardial wall motion capability in patients with stress-related exaggerated hypertension. In this short report, we discussed the interrelation of myocardial dynamics and stress-induced exaggerated hypertension episodes. In addition, quantitative echocardiographic methods which previously were used for description of particular features including LV regional dynamics in hypertensive heart disease can be an option in differential diagnosis of potential cases of acute stress-induced cardiomyopathy.
Department of Cardiology, Johns Hopkins University School of Medicine, Cardiovascular Imaging Center, Baltimore, USA. fyalcin1@jhmi.edu
Fatih
F
Yalçın
Nagehan
N
Küçükler
Theodore P
TP
Abraham
Mario J
MJ
Garcia
D003937:Diagnosis, Differential; D015150:Echocardiography, Doppler; D006801:Humans; D009206:Myocardium; D054549:Takotsubo Cardiomyopathy / Q000000981:diagnostic imaging* / Q000503:physiopathology