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Stress-related cardiomyopathy.

Abdul-Ghani Sankri-Tarbichi1, P K Mathew, Manuel Matos

  • 1Division of Pulmonary/Critical Care and Sleep Medicine, Wayne State University School of Medicine, Detroit, Michigan, USA.

Heart & Lung : the Journal of Critical Care
|January 20, 2007
PubMed
Summary
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Stress-related cardiomyopathy, often overlooked in white populations, typically affects women post-stress and shows good recovery. This case highlights rapid left ventricular function normalization after a stressful event.

Area of Science:

  • Cardiology
  • Cardiovascular Medicine

Background:

  • Stress-related cardiomyopathy (SRC), also known as Takotsubo cardiomyopathy, is increasingly recognized.
  • It predominantly affects women following acute emotional or physical stress.
  • The condition is generally associated with a favorable short-term prognosis and complete recovery.

Observation:

  • A 56-year-old white woman developed acute chest pain and dyspnea after counseling for an endoscopic retrograde cholangiopancreatography procedure due to acute pancreatitis.
  • Electrocardiography showed ischemic changes, and cardiac biomarkers were mildly elevated.
  • Cardiac catheterization revealed normal coronary arteries but a significantly reduced ejection fraction (25%) with apical ballooning.

Findings:

  • The patient presented with classic symptoms and ECG findings suggestive of acute coronary syndrome.

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  • Despite initial cardiac dysfunction, left ventricular function demonstrated remarkable and complete recovery within 10 days.
  • The ejection fraction normalized to 55%.

    • Implications:

    • This case underscores the importance of considering stress-related cardiomyopathy in patients presenting with acute coronary syndromes, especially after stressful events.
    • Early diagnosis and recognition of SRC can prevent unnecessary invasive procedures and guide appropriate management.
    • The rapid functional recovery observed emphasizes the generally benign nature of SRC, though further research into long-term outcomes is warranted.