Stress Induced Cardiomyopathy Triggered by Acute Myocardial Infarction: A Case Series Challenging the Mayo Clinic Definition

Georgios Christodoulidis; Vishwa Kundoor; Edo Kaluski

doi:10.12659/AJCR.902860

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Stress Induced Cardiomyopathy Triggered by Acute Myocardial Infarction: A Case Series Challenging the Mayo Clinic Definition

Journal article

Open access

Stress Induced Cardiomyopathy Triggered by Acute Myocardial Infarction: A Case Series Challenging the Mayo Clinic Definition

Georgios Christodoulidis, Vishwa Kundoor and Edo Kaluski

The American journal of case reports, Vol.18, pp.931-936

08/28/2017

DOI: 10.12659/AJCR.902860

PMCID: PMC5585002

PMID: 28845041

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Abstract

BACKGROUND Various physical and emotional factors have been previously described as triggers for stress induced cardiomyopathy. However, acute myocardial infarction as a trigger has never been reported. CASE REPORT We describe four patients who presented with an acute myocardial infarction, in whom the initial echocardiography revealed wall motion abnormalities extending beyond the coronary distribution of the infarct artery. Of the four patients identified, the mean age was 59 years; three patients were women and two patients had underlying psychiatric history. Electrocardiogram revealed ST elevation in the anterior leads in three patients; QTc was prolonged in all cases. All patients had ≤ moderately elevated troponin. Single culprit lesion was found uniformly in the proximal or mid left anterior descending artery. Initial echocardiography revealed severely reduced ejection fraction with relative sparing of the basal segments, whereas early repeat echocardiography revealed significant improvement in the left ventricular function in all patients. CONCLUSIONS This is the first case series demonstrating that acute myocardial infarction can trigger stress induced cardiomyopathy. Extensive reversible wall motion abnormalities, beyond the ones expected from angiography, accompanied by modest elevation in troponin and marked QTc prolongation, suggest superimposed stress induced cardiomyopathy.

ST Elevation Myocardial Infarction - complications

Takotsubo Cardiomyopathy - etiology

Coronary Occlusion - diagnostic imaging

Humans

Middle Aged

Electrocardiography

Troponin - blood

Female

Male

Aged

Takotsubo Cardiomyopathy - diagnosis

Coronary Occlusion - complications

Details

Title: Subtitle: Stress Induced Cardiomyopathy Triggered by Acute Myocardial Infarction: A Case Series Challenging the Mayo Clinic Definition
Creators: Georgios Christodoulidis - Department of Cardiology, The Guthrie Clinic/Robert Packer Hospital, Sayre, PA, USA
Vishwa Kundoor - Department of Internal Medicine, Guthrie Clinic/Robert Packer Hospital, Sayre, PA, USA
Edo Kaluski - Department of Cardiology, The Guthrie Clinic/Robert Packer Hospital, Sayre, PA, USA
Resource Type: Journal article
Publication Details: The American journal of case reports, Vol.18, pp.931-936
DOI: 10.12659/AJCR.902860
PMID: 28845041
PMCID: PMC5585002
NLM abbreviation: Am J Case Rep
ISSN: 1941-5923
eISSN: 1941-5923
Language: English
Date published: 08/28/2017
Academic Unit: Cardiovascular Medicine; Internal Medicine
Record Identifier: 9984094765502771

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