Stress-Induced Cardiomyopathy: The Role of Echocardiography

Abstract

Echocardiography is widely used to carry out non-invasive cardiac evaluation at the bedside and provides useful real-time information about hemodynamics. It can also be used to diagnose a stress-induced cardiomyopathy and its complications such as shock, heart failure and apical thrombus. Early diagnosis and management are important to prevent possible complications, and short-term follow-up by echocardiography can readily determine the improvement in these abnormalities. In this brief review, we summarize the role of echocardiography in stress-induced cardiomyopathy, with a special focus on its benefits in the era of new emerging diagnostic technology.

Prevalence and Clinical Characteristics of Mental Stress–Induced Myocardial Ischemia in Patients With Coronary Heart Disease

“…Although mental stress, especially MS2 and MS3, induced greater increase of WMA than ES induced, mental and physical stress caused similar regional segments of the left ventricle, that is, greater abnormal wall motion in mid- and apical segments than in basal segments (Fig. 2), a commonly observed phenomena in Takotsubo, or stress-induced cardiomyopathy (35–37). In contrast, mental stress, on average, caused LVEF reduction and the exercise test, on average, resulted in LVEF elevation (Table 1, Fig.…”

“…Other factors that contribute to LVEF changes need to be further investigated. The features of mental stress–induced and exercise stress–induced segmental abnormal wall motion changes are particularly interesting in consideration of the Takotsubo, or stress-induced cardiomyopathy (also known as apical ballooning syndrome) (35–37). The stress–induced greater increase of WMA in the mid- and apical segments than in the basal segments of the left ventricle may reflect a combination of myocardial necrosis and regionally decreased beta-adrenoceptor responsiveness with high local catecholamine concentrations, that is, “neurogenic stunned myocardium” that was suggested by findings from animal studies (39,40).…”

Syndrome Takotsubo: the Value of Echocardiography

“…Хотя в ранних работах предполагалось благоприятное воздействие терапии β-адреноблокаторами, по данным регистров с включением большого числа пациентов с синдромом такоцубо не было обнаружено протективного эффекта β-адреноблокаторов, как при первом эпизоде синдрома такоцубо, так и при его рецидивах [13,19,61]. Комбинированная терапия α-и β-адреноблокаторами может иметь преимущества, но этот вопрос нуждается в уточнении [62]. При выявлении внутрисердечных тромбов показана кратковременная терапия гепарином и антикоагулянтами под пристальным ЭхоКГ-контролем [53].…”

Takotsubo cardiomyopathy in a man with no trigger and multiple cardioembolic complications—A rare constellation

“…15 All 3 conditions present with acute chest pain, elevated troponin, ischemic findings on EKG, 16 and wall-motion abnormalities on echocardiography. 17 Often, invasive coronary angiography is the first diagnostic test in a patient with acute chest pain and elevated cardiac biomarkers, especially if there is ST elevation or ongoing chest pain. 18 Once this shows no epicardial coronary disease characterization and help differentiate it from myocarditis.…”

“…and wall-motion abnormalities on echocardiography 17. Often, invasive coronary angiography is the first diagnostic test in a patient with acute chest pain and elevated cardiac biomarkers, especially if there is ST elevation or ongoing chest pain 18.…”