Anticoagulation and stress-induced cardiomyopathy

Area of Science:

• Cardiology
• Cardiovascular Medicine
• Internal Medicine

Background:

• Stress-induced cardiomyopathy (SCM) is a reversible heart condition with transient systolic dysfunction after acute stress.
• Intracardiac thrombus formation is a significant complication of SCM, with reported rates of 33.3% leading to thromboembolism.
• Risk factors for thrombus include left-ventricular (LV) dysfunction, catecholamine surge, and comorbidities, yet guidelines are lacking.

Purpose of the Study:

• To review the pathophysiology and existing evidence of left-ventricular (LV) thrombus in SCM.
• To provide recommendations for managing intracardiac thrombus in SCM patients.

Main Methods:

• Literature review of pathophysiological theories.
• Analysis of case reports and systematic reviews on LV thrombus in SCM.
• Development of clinical management recommendations based on current evidence.

Main Results:

• SCM-associated LV thrombus risk is linked to LV contraction abnormalities and catecholaminergic surge.
• Lack of clinical trial data hinders established screening and management guidelines.
• Evidence suggests a high frequency of thromboembolic events in patients with SCM-related LV thrombus.

Conclusions:

• Intracardiac thrombus is a serious complication of SCM requiring careful consideration.
• Further clinical trials are needed to establish definitive guidelines for SCM-related thrombus.
• The article proposes evidence-based recommendations for managing intracardiac thrombus in SCM.