Stress cardiomyopathy medical therapy: Difference between revisions

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Revision as of 20:52, 6 January 2017

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Overview

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- and beta blockers seems reasonable.^[1]

Treatment of Complications

The following interventions are done when any of these complications arise:^[1]

Cardiogenic shock is treated with intraaortic balloon pump
Pulomnary edema is treated by putting the patient in an upright position, supplementing them with oxygen and administering diuretics, morphine and sedatives

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.

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[pmid21401402-1] 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.

[1]

@@ Line 4: / Line 4: @@
 ==Overview==
 ==Medical Therapy==
-The treatment of stress cardiomyopathy is supportive as the condition is reversible.  Initial treatment should be similar to that of an acute coronary syndrome with therapy directed at relieving myocardial ischemia with administration of aspirin, intravenous heparin and [[beta blockers]].   Once a diagnosis of stress cardiomyopathy has been confirmed and an acute coronary syndrome excluded, consideration should be given to continuing beta-blocker therapy empirically since catecholamines are suspected of contributing to the syndrome.  Diuretics are effective for the treatment of congestive heart failure.  [[Angiotensin converting enzyme inhibitors]] may be used if the diagnosis is uncertain, until there is complete recovery of systolic function.  Insofar as the left ventricular function and apical wall motion return to normal within days or weeks, long-term anti-coagulation does not appear to be necessary.
+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]] seems 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===
+The following interventions are done when any of these 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>
+*[[Cardiogenic shock]] is treated with [[intraaortic balloon pump]]
+*[[Pulomnary edema]] is treated by putting the patient in an upright position, supplementing them with [[oxygen]] and administering [[diuretics]], [[morphine]] and [[sedatives]]
 ==References==