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Stress-induced cardiomyopathy presenting as acute myocardial infarction
Sun-Young Lee1, Choon-Young Lee, Hyun-Joong Kim
1Department of Medicine, Sungkyunkwan University School of Medicine and Cardiovascular Institute, Samsung Medical Center, Seoul, Korea.
Insights
Stress-induced cardiomyopathy, often triggered by emotional stress, mimics heart attacks but resolves quickly. Prompt diagnosis is key to differentiate it from acute coronary syndromes and ensure proper, non-invasive management.
Area of Science:
- Cardiology
- Neurology
Background:
- Stress-induced cardiomyopathy (SIC) is an acute cardiac condition.
- It results from excessive catecholamine release due to intense emotional stress.
Observation:
- A 64-year-old woman presented with symptoms mimicking acute myocardial infarction following emotional distress.
- Coronary angiography revealed normal findings, ruling out obstructive coronary artery disease.
- Electrocardiograms showed diffuse T wave inversions and left ventriculography indicated akinetic wall motion, sparing basal segments.
Findings:
- The patient's electrocardiogram and echocardiogram normalized completely within four months.
- This case highlights the transient nature of stress-induced cardiomyopathy.
Implications:
- Accurate diagnosis of SIC is crucial to prevent misdiagnosis as acute coronary syndromes.
- Unlike myocardial infarction, SIC demonstrates rapid and favorable recovery with minimal long-term sequelae.
- This underscores the importance of considering emotional triggers in cardiac events.
Abstract:
Stress-induced cardiomyopathy is described as an acute cardiomyopathy that occurs under the influence of an excessive level of catecholamine related to intense emotional stress. A 64-year-old woman presented with symptoms of acute myocardial infarction after emotional upset, but her coronary angiographic findings were revealed to be normal. Diffuse T wave inversions were observed in her electrocardiograms with akinetic wall motions sparing the basal segments in her left ventriculography. After four months, her electrocardiogram and echocardiogram findings had completely returned to normal. The precise diagnosis of this acute cardiomyopathy must be emphasized because it can initially be misdiagnosed as acute coronary syndromes. However in complete contrast to acute myocardial infarction, it has a rapid and favorable recovery with hardly any sequelae after a few months.