Novel developments in stress cardiomyopathy: From pathophysiology to prognosis.
Stress cardiomyopathy (SC) is characterized by transient left ventricular (LV) wall motion abnormalities typically involving the apex with preserved basal contractility, chest discomfort, ST-T ischemic changes and elevated cardiac markers with normal or non-flow limiting coronary artery lesions. It represents an important differential diagnosis of Acute Coronary Syndromes caused by atherosclerotic vessel occlusion; most commonly, Tako-tsubo occurs in postmenopausal women after physical or emotional stress. While the exact mechanism of SC remains controversial, various hypotheses have been suggested concerning the vascular, central nervous and endocrine system participation where catecholamines, particularly epinephrine, seem to play a major role. Hormonal, genetic and psychiatric conditions may also define the risk of susceptibility in some groups affected by SC. Long-term survival data are limited with mortality occurring predominantly in the first year after diagnosis usually related to non-cardiac illnesses. Echocardiography promises to become a useful tool to correctly identify SC patients at high risk for complications.
Department of Cardiology, Cedimat Cardiovascular Center, Santo Domingo, Dominican Republic.
Ana
A
Goico
Department of Medicine, Section of Cardiology, Advocate Illinois Masonic Medical Center, Chicago, IL, United States.
Mercy
M
Chandrasekaran
Department of Cardiology, Cedimat Cardiovascular Center, Santo Domingo, Dominican Republic. Electronic address: cjherrera@cedimat.net.
Cesar J
CJ
Herrera
D003937:Diagnosis, Differential; D004452:Echocardiography / Q000379:methods; D004562:Electrocardiography / Q000379:methods; D006801:Humans; D011379:Prognosis; D012307:Risk Factors; D054549:Takotsubo Cardiomyopathy / Q000175:diagnosis / Q000401:mortality / Q000503:physiopathology
Apical ballooning; Neurocardiogenic stunning; Stress cardiomyopathy; Tako-tsubo