Stress cardiomyopathy medical therapy: Difference between revisions
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__NOTOC__ | __NOTOC__ | ||
{{Stress cardiomyopathy}} | {{Stress cardiomyopathy}} | ||
{{CMG}} | {{CMG}}; {{AE}}{{DN}} | ||
==Overview== | ==Overview== | ||
Medical therapy in stress cardiomyopathy is indicated to treat the complications that may arise. The most common complications related to stress cardiomyopathy include [[heart failure]] and [[pulmonary edema]]. [[Diuretics]] and medications for[[heart failure]] constitute the treatment of choice in these conditions. | |||
==Medical Therapy== | ==Medical Therapy== | ||
Medical therapy in patients with stress cardiomyopathy is mostly targeted towards the treatment of complications. For stress cardiomyopathy per se, the use of [[heparin]] and [[aspirin]] are controversial. It must be noted that the use of [[beta blockers]] alone is not advised, as this will result unopposed activity of [[catecholamines]] at the [[alpha receptors]] and further prolongation of the [[QT interval]]. The combined use of [[alpha blockers|alpha-]] and [[beta blockers]] | Medical therapy in patients with stress cardiomyopathy is mostly targeted towards the treatment of complications. For stress cardiomyopathy per se, the use of [[heparin]] and [[aspirin]] are controversial. It must be noted that the use of [[beta blockers]] alone is not advised, as this will result unopposed activity of [[catecholamines]] at the [[alpha receptors]] and can cause further prolongation of the [[QT interval]]. The combined use of [[alpha blockers|alpha-]] and [[beta blockers]] is reasonable.<ref name="pmid21401402">{{cite journal |vauthors=Omerovic E |title=How to think about stress-induced cardiomyopathy?--Think "out of the box"! |journal=Scand. Cardiovasc. J. |volume=45 |issue=2 |pages=67–71 |year=2011 |pmid=21401402 |doi=10.3109/14017431.2011.565794 |url=}}</ref> | ||
===Treatment of Complications=== | ===Treatment of Complications=== | ||
The following interventions are | The following interventions are performed if their associated complications arise:<ref name="pmid21401402">{{cite journal |vauthors=Omerovic E |title=How to think about stress-induced cardiomyopathy?--Think "out of the box"! |journal=Scand. Cardiovasc. J. |volume=45 |issue=2 |pages=67–71 |year=2011 |pmid=21401402 |doi=10.3109/14017431.2011.565794 |url=}}</ref><ref name="pmid18206521">{{cite journal |vauthors=Brenner ZR, Powers J |title=Takotsubo cardiomyopathy |journal=Heart Lung |volume=37 |issue=1 |pages=1–7 |year=2008 |pmid=18206521 |doi=10.1016/j.hrtlng.2006.12.003 |url=}}</ref><ref name="pmid">{{cite journal |vauthors=Bybee KA, Kara T, Prasad A, Lerman A, Barsness GW, Wright RS, Rihal CS |title=Systematic review: transient left ventricular apical ballooning: a syndrome that mimics ST-segment elevation myocardial infarction |journal=Ann. Intern. Med. |volume=141 |issue=11 |pages=858–65 |year=2004 |pmid= |doi= |url=}}</ref> | ||
*[[Cardiogenic shock]] is treated with [[intraaortic balloon pump]] | *[[Cardiogenic shock]] is treated with [[intraaortic balloon pump]] | ||
*[[Pulmonary edema]] is treated by | *[[Pulmonary edema]] is treated by advising the patient to adopt an upright position, supplementation of [[oxygen]], and administration of [[diuretics]], [[morphine]] and [[sedatives]] | ||
*Heart failure is managed | *[[Heart failure]] is managed [[ACE inhibitor|ACE inhibitors]], [[Angiotensin II receptor antagonist|ARBs]], [[diuretics]] and [[nitrates]] | ||
==References== | ==References== |
Latest revision as of 20:37, 1 February 2019
Stress cardiomyopathy Microchapters |
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Unstable angina/non ST elevation myocardial infarction in Stress (Takotsubo) Cardiomyopathy |
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Risk calculators and risk factors for Stress cardiomyopathy medical therapy |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Dima Nimri, M.D. [2]
Overview
Medical therapy in stress cardiomyopathy is indicated to treat the complications that may arise. The most common complications related to stress cardiomyopathy include heart failure and pulmonary edema. Diuretics and medications forheart failure constitute the treatment of choice in these conditions.
Medical Therapy
Medical therapy in patients with stress cardiomyopathy is mostly targeted towards the treatment of complications. For stress cardiomyopathy per se, the use of heparin and aspirin are controversial. It must be noted that the use of beta blockers alone is not advised, as this will result unopposed activity of catecholamines at the alpha receptors and can cause further prolongation of the QT interval. The combined use of alpha- and beta blockers is reasonable.[1]
Treatment of Complications
The following interventions are performed if their associated complications arise:[1][2][3]
- Cardiogenic shock is treated with intraaortic balloon pump
- Pulmonary edema is treated by advising the patient to adopt an upright position, supplementation of oxygen, and administration of diuretics, morphine and sedatives
- Heart failure is managed ACE inhibitors, ARBs, diuretics and nitrates
References
- ↑ 1.0 1.1 Omerovic E (2011). "How to think about stress-induced cardiomyopathy?--Think "out of the box"!". Scand. Cardiovasc. J. 45 (2): 67–71. doi:10.3109/14017431.2011.565794. PMID 21401402.
- ↑ Brenner ZR, Powers J (2008). "Takotsubo cardiomyopathy". Heart Lung. 37 (1): 1–7. doi:10.1016/j.hrtlng.2006.12.003. PMID 18206521.
- ↑ Bybee KA, Kara T, Prasad A, Lerman A, Barsness GW, Wright RS, Rihal CS (2004). "Systematic review: transient left ventricular apical ballooning: a syndrome that mimics ST-segment elevation myocardial infarction". Ann. Intern. Med. 141 (11): 858–65.