Stress cardiomyopathy differential diagnosis: Difference between revisions
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__NOTOC__ | __NOTOC__ | ||
{{Stress cardiomyopathy}} | {{Stress cardiomyopathy}} | ||
{{CMG}} | {{CMG}}; {{AE}}{{DN}} {{AKK}} | ||
==Overview== | ==Overview== | ||
The clinical presentation, laboratory findings and imaging studies of stress cardiomyopathy resembles that of [[anterior MI]] and must be differentiated from it. Also, stress cardiomyopathy must be differentiated from Takotsubo-like cardiomyopathy, such as that due to [[pheochromocytoma]]. | |||
== Differentiating Stress Cardiomyopathy from other Diseases == | == Differentiating Stress Cardiomyopathy from other Diseases == | ||
The presentation of stress cardiomyopathy mimics that of [[Anterior myocardial infarction|anterior wall MI]] and must be differentiated from it | The presentation of stress cardiomyopathy mimics that of [[Anterior myocardial infarction|anterior wall MI]] and must be differentiated from it. There are some studies in the literature comparing left ventricular functions between acute myocardial infarction and stress cardiomyopathy. Although, [[systolic]] functions of the [[left ventricle]] were more impaired in stress cardiomyopathy group compared with [[acute myocardial infarction]] group, [[diastolic]] functions were better in these patients. <ref name="pmid24503950">{{cite journal| author=Medeiros K, O'Connor MJ, Baicu CF, Fitzgibbons TP, Shaw P, Tighe DA et al.| title=Systolic and diastolic mechanics in stress cardiomyopathy. | journal=Circulation | year= 2014 | volume= 129 | issue= 16 | pages= 1659-67 | pmid=24503950 | doi=10.1161/CIRCULATIONAHA.113.002781 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=24503950 }} </ref> <ref name="pmid19483168">{{cite journal| author=Park SM, Prasad A, Rihal C, Bell MR, Oh JK| title=Left ventricular systolic and diastolic function in patients with apical ballooning syndrome compared with patients with acute anterior ST-segment elevation myocardial infarction: a functional paradox. | journal=Mayo Clin Proc | year= 2009 | volume= 84 | issue= 6 | pages= 514-21 | pmid=19483168 | doi=10.1016/S0025-6196(11)60583-1 | pmc=2688625 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=19483168 }} </ref> | ||
{| class="wikitable" | {| class="wikitable" | ||
! | !Disease | ||
! | !Can Present With | ||
! | !Cardiac Enzymes | ||
!Catecholamine Levels | |||
!ECG Findings | |||
!Echocardiography Findings | |||
|- | |- | ||
|[[Chest pain]] | |Stress Cardiomyopathy | ||
| | |[[Chest pain]], [[dyspnea]] | ||
| | |↑ | ||
|Transiently elevated | |||
|[[ST elevation]] in [[precordial leads]] | |||
|[[LV]] regional dysfunction | |||
|- | |- | ||
|[[Pheochromocytoma]] | |||
|[[Chest pain]], [[dyspnea]] | |||
|Can be positive | |||
|Persistently elevated | |||
|[[ST elevation]] in [[precordial leads]] | |[[ST elevation]] in [[precordial leads]] | ||
| | |[[LV]] regional dysfunction | ||
|- | |- | ||
| | |[[Anterior MI]] | ||
| | |[[Chest pain]], [[dyspnea]] | ||
|↑↑↑ | |↑↑↑ | ||
| - | |||
|[[ST elevation]] in [[precordial leads]] | |||
|Dysfunction at area of [[infarction]] | |||
|- | |- | ||
| | |[[Myocarditis]] | ||
|[[Chest pain]], [[dyspnea]], [[fever]] | |||
|May be acutely elevated | |||
| - | |||
|May show [[atrial fibrillation]], [[Left bundle branch block|LBBB]] or [[AV block]] | |||
|Diffuse [[hypokinesia]] | |||
| | |||
| | |||
|- | |||
|[[ | |||
| | |||
|- | |- | ||
|[[ | |[[Dilated cardiomyopathy|Dilated Cardiomyopathy]] | ||
| | |[[Dyspnea]], [[dyspnea on exertion]], [[cough]], [[edema]], [[fatigue]] | ||
| | |Usually negative | ||
| - | |||
|May show [[atrial fibrillation]], [[Left bundle branch block|LBBB]] or [[AV block]] | |||
|[[LV]] enlargement | |||
|- | |- | ||
| | |[[Hypertrophic Cardiomyopathy]] | ||
| | |[[Chest pain]], [[dyspnea]], [[syncope]], [[sudden cardiac death]] | ||
| | |Usually negative | ||
* [[ | | - | ||
* [[ | |Common findings include: | ||
* | * [[Right axis deviation|Right]] or [[left axis deviation]] | ||
* [[Bundle branch block|BBB]] | |||
* [[Sinus bradycardia]] | |||
|[[LV hypertrophy]], [[systolic]] anterior motion of the [[mitral valve]], asymmetric septal [[hypertrophy]] | |||
|} | |} | ||
Latest revision as of 18:55, 1 February 2019
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Stress cardiomyopathy Microchapters |
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Diagnosis |
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Treatment |
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Unstable angina/non ST elevation myocardial infarction in Stress (Takotsubo) Cardiomyopathy |
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Case Studies |
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Stress cardiomyopathy differential diagnosis On the Web |
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American Roentgen Ray Society Images of Stress cardiomyopathy differential diagnosis |
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Risk calculators and risk factors for Stress cardiomyopathy differential diagnosis |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Dima Nimri, M.D. [2] Arzu Kalayci, M.D. [3]
Overview
The clinical presentation, laboratory findings and imaging studies of stress cardiomyopathy resembles that of anterior MI and must be differentiated from it. Also, stress cardiomyopathy must be differentiated from Takotsubo-like cardiomyopathy, such as that due to pheochromocytoma.
Differentiating Stress Cardiomyopathy from other Diseases
The presentation of stress cardiomyopathy mimics that of anterior wall MI and must be differentiated from it. There are some studies in the literature comparing left ventricular functions between acute myocardial infarction and stress cardiomyopathy. Although, systolic functions of the left ventricle were more impaired in stress cardiomyopathy group compared with acute myocardial infarction group, diastolic functions were better in these patients. [1] [2]
| Disease | Can Present With | Cardiac Enzymes | Catecholamine Levels | ECG Findings | Echocardiography Findings |
|---|---|---|---|---|---|
| Stress Cardiomyopathy | Chest pain, dyspnea | ↑ | Transiently elevated | ST elevation in precordial leads | LV regional dysfunction |
| Pheochromocytoma | Chest pain, dyspnea | Can be positive | Persistently elevated | ST elevation in precordial leads | LV regional dysfunction |
| Anterior MI | Chest pain, dyspnea | ↑↑↑ | - | ST elevation in precordial leads | Dysfunction at area of infarction |
| Myocarditis | Chest pain, dyspnea, fever | May be acutely elevated | - | May show atrial fibrillation, LBBB or AV block | Diffuse hypokinesia |
| Dilated Cardiomyopathy | Dyspnea, dyspnea on exertion, cough, edema, fatigue | Usually negative | - | May show atrial fibrillation, LBBB or AV block | LV enlargement |
| Hypertrophic Cardiomyopathy | Chest pain, dyspnea, syncope, sudden cardiac death | Usually negative | - | Common findings include: | LV hypertrophy, systolic anterior motion of the mitral valve, asymmetric septal hypertrophy |
References
- ↑ Medeiros K, O'Connor MJ, Baicu CF, Fitzgibbons TP, Shaw P, Tighe DA; et al. (2014). "Systolic and diastolic mechanics in stress cardiomyopathy". Circulation. 129 (16): 1659–67. doi:10.1161/CIRCULATIONAHA.113.002781. PMID 24503950.
- ↑ Park SM, Prasad A, Rihal C, Bell MR, Oh JK (2009). "Left ventricular systolic and diastolic function in patients with apical ballooning syndrome compared with patients with acute anterior ST-segment elevation myocardial infarction: a functional paradox". Mayo Clin Proc. 84 (6): 514–21. doi:10.1016/S0025-6196(11)60583-1. PMC 2688625. PMID 19483168.