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Updated: Jul 17, 2026
Murine Isolated Heart Model of Myocardial Stunning Associated with Cardioplegic Arrest
Published on: August 6, 2015
[The "broken heart" syndrome--a rare clinical phenomenon]
T Kleinfeldt1, S Drawert, H Schneider
1Universität Rostock, Klinik und Poliklinik für Innere Medizin, Abteilung Kardiologie.
Insights
A stress-induced cardiomyopathy can mimic acute coronary syndrome (ACS) but has a favorable outcome. This condition, characterized by reversible left ventricular dysfunction, is often triggered by emotional stress and may be more common in postmenopausal women.
Area of Science:
- Cardiology
- Cardiomyopathy
- Stress-induced cardiomyopathy
Context:
- A clinical entity mimicking acute coronary syndrome (ACS) was identified in 6 patients.
- Patients presented with chest pain, ST-segment elevation, and/or T-wave inversion.
- The condition was triggered by severe psychological stress.
Purpose:
- To identify and characterize a clinical entity mimicking ACS.
- To analyze patients with transient left ventricular dysfunction triggered by emotional stress.
- To investigate the clinical presentation and outcomes of stress-induced cardiomyopathy.
Summary:
- Six patients with acute chest pain and electrocardiographic changes, but normal coronary arteries, were studied.
- All patients exhibited transient left ventricular systolic dysfunction (apical ballooning) triggered by emotional stress.
- The condition, a form of stress-induced cardiomyopathy, resolved with a favorable prognosis.
Impact:
- Identifies a distinct clinical entity that can be mistaken for acute coronary syndrome.
- Highlights the role of emotional stress in precipitating cardiac events.
- Suggests a higher prevalence in postmenopausal women and emphasizes a good recovery outlook.
Background And Objective:
A clinical entity that mimics acute coronary syndrome with reversible left ventricular systolic dysfunction and is triggered by emotional stress was identified in 6 patients by screening a database of > 1000 patients with the ICD-10 coding of acute coronary syndrome. The search criteria were acute coronary syndrome, normal coronary anatomy, absence of coronary lesions and transient left ventricular dysfunction, triggered by emotional stress.
Patients And Methods:
We analyzed 6 patients, who fulfilled the criteria of (1) acute substernal chest pain with ST-segment elevation and/or T-wave inversion; (2) absence of significant coronary arterial narrowing on angiography, (3) systolic dysfunction with abnormal regional wall motion ("apical ballooning") in the context of (4) severe psychological stress immediately before and triggering the cardiac events.
Results:
The primary diagnosis for all 6 acutely ill patients accorded with the ICD-code of acute coronary syndrome. All patients had survived and eventually recovered with an LV ejection fraction of 60 +/- 5 %; P = 0.03 and had had recovered normal levels of physical activity at hospital discharge. Of note is the number of women of postmenopausal age.
Conclusions:
A transient cardiomyopathy triggered by major emotional stress may mimic an acute coronary syndrome but without significant coronary artery disease. This condition is characterized by reversible cardiac dysfunction and may be more frequent in women. It has a favorable clinical outcome.
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