Stress Cardiomyopathy Complicated by Left Ventricular Thrombi and Cerebral Infarctions in a Patient with Essential Thrombocythemia

Abstract

The prognosis of stress induced cardiomyopathy (SCMP) is generally known to be excellent, however, several fatal complications such as cardiac rupture and left ventricular (LV) thrombosis with subsequent embolic complications have been described. We report a rare case of SCMP complicated by LV thrombosis and multiple cerebral infarctions in a patient with essential thrombocythemia. After intravenous anticoagulation with heparin and general managements for heart failure and cerebral infarctions, her neurologic symptoms and the wall motion abnormalities of the LV apex were improved, and the thrombus was disappeared on follow-up echocardiography.

Pheochromocytoma as a Rare Hidden Cause of Inverted Stress Cardiomyopathy

“…Although SCMP has been reported from the early 1990s, the cause or pathophysiologic mechanism of SCMP is still unclear 1,2,3). Various emotional or physical stressors have been described as predisposing conditions of SCMP, but these precipitating stressors, as in the present case, are not identified in some cases.…”

“…Stress cardiomyopathy (SCMP), also known as takotsubo cardiomyopathy or apical ballooning syndrome, is now a well established disease entity and characterized by rapid and severe reversible cardiac dysfunction without significant coronary arterial stenosis. 1 , 2 , 3) Emotional or physical stressors have been described as triggering factors of this syndrome, but these precipitating stressors are not identified in some cases. Recently, catecholamine excess has been implicated as a possible pathophysiologic mechanism of SCMP, but the association between catecholamine excess and SCMP is unclear.…”