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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

Summary

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.

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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.
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.