Related Experiment Video
Updated: Jul 8, 2026
10:08
Tachycardia-Induced Cardiomyopathy As a Chronic Heart Failure Model in Swine
Published on: February 17, 2018
Stress-induced cardiomyopathy: not always apical ballooning
Wissam Derian1, Dwarakraj Soundarraj, Michael J Rosenberg
1Division of Cardiology, Advocate Lutheran General Hospital, Park Ridge, Illinois, USA.
Reviews in Cardiovascular Medicine
|January 15, 2008
Summary
Stress-induced cardiomyopathy, often called takotsubo syndrome, can affect any heart wall, not just the apex. This study found that abnormal heart motion in these cases can occur in various segments and fully resolves over time.
Area of Science:
- Cardiology
- Cardiovascular Medicine
- Internal Medicine
Background:
- Apical ballooning, or takotsubo syndrome, is a condition mimicking myocardial infarction with transient apical dysfunction and normal coronary arteries.
- It is frequently triggered by emotional or physical stress, with increasing recognition contributing to its apparent rise in prevalence.
- The exact pathophysiological mechanisms underlying takotsubo syndrome remain incompletely understood, despite various proposed hypotheses.
Purpose of the Study:
- To investigate the variability in myocardial wall motion abnormalities in patients presenting with symptoms of acute myocardial infarction and normal coronary arteries.
- To determine if stress-induced cardiomyopathy is exclusively limited to apical segments or if it can manifest in other myocardial regions.
- To analyze the recovery patterns of myocardial function in affected patients.
Main Methods:
- Retrospective data collection from 12 patients diagnosed with acute myocardial infarction and normal coronary arteries but exhibiting abnormal wall motion.
- Classification of patients into typical apical ballooning (5 patients) and those with abnormalities in other segments (7 patients).
- Review of serial cardiac studies to confirm complete healing of wall motion abnormalities.
Main Results:
- Takotsubo syndrome can present with wall motion abnormalities in myocardial segments beyond the apex.
- Seven out of twelve patients (58%) demonstrated abnormal wall motion in non-apical regions.
- All documented wall motion abnormalities, regardless of location, showed complete resolution on follow-up studies.
Conclusions:
- Stress-induced cardiomyopathy is not invariably characterized by apical ballooning.
- The clinical presentation of takotsubo syndrome can involve diverse myocardial segments.
- These findings suggest a broader spectrum of regional involvement in stress-induced cardiomyopathy than previously emphasized.
Related Concept Videos
01:25Cardiomyopathy I: Introduction and Classification
Cardiomyopathy, or CMP, is a group of diseases affecting the myocardial structure, impairing its ability to pump blood effectively. This condition can lead to arrhythmias, heart failure, or sudden cardiac death.Cardiomyopathies are classified into primary and secondary categories:Primary Cardiomyopathy refers to conditions involving only the heart muscle that are often idiopathic (of unknown cause) or genetic. They primarily affect the myocardium without the involvement of other systemic...
01:29Cardiomyopathy III: Hypertrophic Cardiomyopathy
Hypertrophic cardiomyopathy, or HCM, is an autosomal dominant genetic disorder characterized by asymmetric left ventricular hypertrophy without ventricular dilation. It is more common in men and is typically diagnosed in young, athletic adults.EtiologyHCM is primarily genetic and is caused by mutations in genes encoding sarcomeric proteins. Researchers have identified over 1400 mutations across at least 11 different genes. Among these, the most frequently occurring mutations are found in the...
01:30Cardiomyopathy II: Dilated Cardiomyopathy
Dilated cardiomyopathy, or DCM, is a progressive myocardial disorder characterized by ventricular chamber dilation and contractile dysfunction.EtiologyVarious factors can cause DCM, including hypertension and heavy alcohol intake, which contribute to the weakening and enlargement of the heart muscle. Viral infections, such as Coxsackievirus B, adenoviruses, and influenza, can lead to DCM by causing inflammation and damage to heart tissue. Certain chemotherapeutic agents, including daunorubicin,...
01:29Cardiomyopathy IV: Restrictive Cardiomyopathy
Restrictive cardiomyopathy (RCM) is a rare heart muscle disease characterized by impaired ventricular filling due to stiffened ventricular walls, leading to significant diastolic dysfunction.EtiologyRestrictive cardiomyopathy can arise from both inherited and acquired diseases, many of which are systemic. It is categorized into four main types: infiltrative, storage, non-infiltrative, and endomyocardial diseases.Infiltrative diseases, such as amyloidosis, lead to RCM by depositing amyloid...
01:21Myocarditis I: Introduction
Myocarditis is inflammation of the myocardium, which is the muscular layer of the heart.EtiologyMyocarditis has a diverse etiology, including a wide range of infectious and non-infectious causes:Infectious CausesViral: Common viruses include Coxsackie A and B, adenovirus, parvovirus B19, enteroviruses, and influenza A.Bacterial: Examples include infections caused by Streptococcus, Staphylococcus, and Mycoplasma species.Rickettsial: Infections like Rocky Mountain spotted fever can result in...
01:26Imbalances in Cardiac Output
The heart's primary function is to pump blood throughout the body, maintaining a balance between blood sent out (cardiac output) and blood returning (venous return). If this balance is disrupted, it can result in congestive heart failure (CHF), a severe condition where the heart becomes an inefficient pump, leading to inadequate blood circulation.
CHF can occur due to the failure of either side of the heart. Left-side failure leads to pulmonary congestion—the right side continues to send blood...
CHF can occur due to the failure of either side of the heart. Left-side failure leads to pulmonary congestion—the right side continues to send blood...