title: A novel approach to the diagnosis of stress-induced cardiomyopathy.
abstract: Stress-induced cardiomyopathy is becoming a more commonly recognized diagnosis, accounting for 2% to 3% of patients presenting with signs and symptoms of acute anterior myocardial infarction. We present the case of a 68-year-old man with dyspnea 9 days after an unrelated operation. After hospital admission, he complained of chest pain, and an electrocardiogram demonstrated ST-segment elevation in the anterolateral and inferior leads, ST-segment depression in lead aVR, and an absence of ST-segment changes in lead V(1). Cardiac biomarker levels were elevated. Transthoracic echocardiography demonstrated a left ventricular ejection fraction of 30% to 40%, basilar hyperactivity, apical dyskinesia, and distal inferior and anterior akinesia. Cardiac catheterization did not reveal any culprit obstructive lesion. He received a diagnosis of stress-induced cardiomyopathy and was treated according to established recommendations for systolic heart failure. His cardiac biomarkers returned to normal, and a repeated transthoracic echocardiogram 3 days later revealed nearly complete resolution of myocardial wall-motion abnormalities.
authors.affiliation: Department of Medicine, Dwight D. Eisenhower Army Medical Center, Fort Gordon, GA 30905-5741, USA. jered.haynor@amedd.army.mil
authors.forename: Jered
authors.initials: J
authors.lastname: Haynor
authors.forename: Christopher
authors.initials: C
authors.lastname: Colombo
authors.forename: Sean
authors.initials: S
authors.lastname: Javaheri
mesh_terms: D000368:Aged; D019917:Blood Vessel Prosthesis Implantation / Q000009:adverse effects; D006333:Heart Failure / Q000175:diagnosis / Q000209:etiology / Q000628:therapy; D006801:Humans; D008297:Male; D013315:Stress, Psychological / Q000150:complications; D054549:Takotsubo Cardiomyopathy / Q000175:diagnosis* / Q000209:etiology / Q000628:therapy