Current Heart Failure Reports

, 6:265

Stress cardiomyopathy syndrome: A contemporary review

Article

Abstract

Stress cardiomyopathy (SC) syndrome represents a reversible form of cardiomyopathy that commonly presents proximate to an acute emotional or physiologic stressor. The clinical presentation is similar to an acute coronary syndrome in the absence of obstructive coronary artery disease to explain the unusual distribution of associated transient wall motion abnormalities. Postmenopausal women seem particularly prone to SC for unclear reasons. The pathophysiology of the syndrome is unknown but may involve pathologic sympathetic myocardial stimulation.

References and Recommended Reading

  1. 1.
    Dote K, Sato H, Tateishi H, et al.: Myocardial stunning due to simultaneous multivessel coronary spasms: a review of 5 cases. J Cardiol 1991, 21:203–214.PubMedGoogle Scholar
  2. 2.
    Sharkey SW, Lesser JR, Zenovich AG, et al.: Acute and reversible cardiomyopathy provoked by stress in women from the United States. Circulation 2005, 111:472–479.CrossRefPubMedGoogle Scholar
  3. 3.
    Wittstein IS, Thiemann DR, Lima JA, et al.: Neurohumoral features of myocardial stunning due to sudden emotional stress. N Engl J Med 2005, 352:539–548.CrossRefPubMedGoogle Scholar
  4. 4.
    Gelow J, Kruer M, Yadav V, Kaul S: Apical ballooning resulting from limbic encephalitis. Am J Med 2009, 122:583–586.CrossRefPubMedGoogle Scholar
  5. 5.
    Bose A, Chuprun D, Kerstein J: Inferior vena cava filter thrombosis causing transient apical ballooning. Am J Med 2009, 122:e1–e2.CrossRefPubMedGoogle Scholar
  6. 6.
    Citro R, Previtali M, Bossone E: Tako-tsubo cardiomyopathy and drowning syndrome: is there a link? Chest 2008, 134:469.CrossRefGoogle Scholar
  7. 7.
    Guerrero J, Majid A, Ernst A: Cardiogenic shock secondary to Tako-tsubo syndrome after debridement of malignant endobronchial obstruction. Chest 2009, 135:217–220.CrossRefPubMedGoogle Scholar
  8. 8.
    Roock S, Beauloye C, Bauwer De, et al.: Tako-tsubo syndrome following nortriptyline overdose. Clin Toxicol 2008, 46:475–478.CrossRefGoogle Scholar
  9. 9.
    Osuorji I, Williams C, Hessney J, et al.: Acute stress cardiomyopathy following treatment of status asthmaticus. South Med J 2009, 102:301–303.PubMedGoogle Scholar
  10. 10.
    Nichols T, Houry D: Elevated cardiac enzymes and ECG changes after blunt trauma in an elderly woman. South Med J 2008, 101:106–107.PubMedGoogle Scholar
  11. 11.
    Crimi E, Baggish A, Leffert L, et al.: Images in cardiovascular medicine. Acute reversible stress-induced cardiomyopathy associated with cesarean delivery under spinal anesthesia. Circulation 2008, 117:3052–3053.CrossRefPubMedGoogle Scholar
  12. 12.
    Kogan A, Ghosh P, Schwammenthal E, Raanani E: Takotsubo syndrome after cardiac surgery. Ann Thorac Surg 2008, 85:1439–1441.CrossRefPubMedGoogle Scholar
  13. 13.
    Maron BJ, Towbin JA, Thiene G et al.: Contemporary definitions and classification of the cardiomyopathies: an American Heart Association Scientific Statement from the Council on Clinical Cardiology, Heart Failure and Transplantation Committee; Quality of Care and Outcomes Research and Functional Genomics and Translational Biology Interdisciplinary Working Groups; and Council on Epidemiology and Prevention. Circulation 2006, 113:1807–1816.CrossRefPubMedGoogle Scholar
  14. 14.
    Dib C, Asirvatham S, Elesber A, et al.: Clinical correlates and prognostic significance of electrocardiographic abnormalities in apical ballooning syndrome (Takotsubo/stress-induced cardiomyopathy). Am Heart J 2009, 157:933–938.CrossRefPubMedGoogle Scholar
  15. 15.
    Sharkey SW, Lesser JR, Menon M, et al.: Spectrum and significance of electrocardiographic patterns, troponin levels, and thrombolysis in myocardial infarction frame count in patients with stress (tako-tsubo) cardiomyopathy and comparison to those in patients with ST-elevation anterior wall myocardial infarction. Am J Cardiol 2008, 101:1723–1728.CrossRefPubMedGoogle Scholar
  16. 16.
    Kurisu S, Inoue I, Kawagoe T, et al.: Time course of electrocardiographic changes in patients with tako-tsubo syndrome: comparison with acute myocardial infarction with minimal enzymatic release. Circ J 2004, 68:77–81.CrossRefPubMedGoogle Scholar
  17. 17.
    Matsuoka K, Okubo S, Fujii E, et al.: Evaluation of the arrhythmogenicity of stress-induced “Takotsubo cardiomyopathy” from the time course of the 12-lead surface electrocardiogram. Am J Cardiol 2003, 92:230–233.CrossRefPubMedGoogle Scholar
  18. 18.
    Brenner ZR, Powers J: Takotsubo cardiomyopathy. Heart Lung 2008, 37:1–7.CrossRefPubMedGoogle Scholar
  19. 19.
    Ramaraj R, Sorrell VL, Movahed MR: Levels of troponin release can aid in the early exclusion of stress-induced (takotsubo) cardiomyopathy. Exp Clin Cardiol 2009, 14:6–8.PubMedGoogle Scholar
  20. 20.
    Hahn JY, Gwon HC, Park SW, et al.: The clinical features of transient left ventricular nonapical ballooning syndrome: comparison with apical ballooning syndrome. Am Heart J 2007, 154:1166–1173.CrossRefPubMedGoogle Scholar
  21. 21.
    Sanchez-Recalde A, Costero O, Oliver JM, et al.: Images in cardiovascular medicine. Pheochromocytoma-related cardiomyopathy: inverted Takotsubo contractile pattern. Circulation 2006, 113:e738–e739.CrossRefPubMedGoogle Scholar
  22. 22.
    El Mahmoud R, Mansencal N, Pilliére R, et al.: Prevalence and characteristics of left ventricular outflow tract obstruction in Tako-Tsubo syndrome. Am Heart J 2008, 156:543–548.CrossRefPubMedGoogle Scholar
  23. 23.
    Parodi G, Del Pace S, Salvadori C, et al.: Left ventricular apical ballooning syndrome as a novel cause of acute mitral regurgitation. J Am Coll Cardiol 2007, 50:647–649.CrossRefPubMedGoogle Scholar
  24. 24.
    Leurent G, Larralde A, Boulmier D, et al.: Cardiac MRI studies of transient left ventricular apical ballooning syndrome (takotsubo cardiomyopathy): a systematic review. Int J Cardiol 2009, 135:146–149.CrossRefPubMedGoogle Scholar
  25. 25.
    Bybee KA, Kara T, Prasad A, et al.: Systematic review: transient left ventricular apical ballooning: a syndrome that mimics ST-segment elevation myocardial infarction. Ann Intern Med 2004, 141:858–865.PubMedGoogle Scholar
  26. 26.
    Bybee KA, Prasad A, Barsness GW, et al.: Clinical characteristics and thrombolysis in myocardial infarction frame counts in women with transient left ventricular apical ballooning syndrome. Am J Cardiol 2004, 94:343–346.CrossRefPubMedGoogle Scholar
  27. 27.
    Ito K, Sugihara H, Katoh S, et al.: Assessment of Takotsubo (ampulla) cardiomyopathy using 99mTc-tetrofosmin myocardial SPECT-comparison with acute coronary syndrome. Ann Nucl Med 2003, 17:115–122.CrossRefPubMedGoogle Scholar
  28. 28.
    Patrignani A, Di Cesare E, Cicogna S: Echocardiography and cardiovascular magnetic resonance diagnostic role in Takotsubo cardiomyopathy. Int J Cardiovasc Imaging 2009, 25:109–112.CrossRefPubMedGoogle Scholar
  29. 29.
    Ito K, Sugihara H, Kinoshita N, et al.: Assessment of Takotsubo cardiomyopathy (transient left ventricular apical ballooning) using 99mTc-tetrofosmin, 123I-BMIPP, 123IMIBG and 99mTc-PYP myocardial SPECT. Ann Nucl Med 2005, 19:435–445.CrossRefPubMedGoogle Scholar
  30. 30.
    Park SM, Prasad A, Rihal C, et al.: 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 2009, 84:514–521.CrossRefPubMedGoogle Scholar
  31. 31.
    Bybee KA, Murphy J, Prasad A, et al.: Acute impairment of regional myocardial glucose uptake in the apical ballooning (takotsubo) syndrome. J Nucl Cardiol 2006, 13:244–250.PubMedGoogle Scholar
  32. 32.
    Yoshida T, Hibino T, Kako N, et al.: A pathophysiologic study of tako-tsubo cardiomyopathy with F-18 fluorodeoxyglucose positron emission tomography. Eur Heart J 2007, 28:2598–2604.CrossRefPubMedGoogle Scholar
  33. 33.
    Akashi YJ, Nakazawa K, Sakakibara M, et al.: 123I-MIBG myocardial scintigraphy in patients with “takotsubo” cardiomyopathy. J Nucl Med 2004, 45:1121–1127.PubMedGoogle Scholar
  34. 34.
    Mitchell JH, Hadden TB, Wilson JM, et al.: Clinical features and usefulness of cardiac magnetic resonance imaging in assessing myocardial viability and prognosis in Takotsubo cardiomyopathy (transient left ventricular apical ballooning syndrome). Am J Cardiol 2007, 100:296–301.CrossRefPubMedGoogle Scholar
  35. 35.
    Cevik C, Otahbachi M, Miller E, et al.: Acute stress cardiomyopathy and deaths associated with electronic weapons. Int J Cardiol 2009, 132:312–317.CrossRefPubMedGoogle Scholar
  36. 36.
    Sharkey SW, Maron BJ, Nelson P, et al.: Adrenergic receptor polymorphisms in patients with stress (tako-tsubo) cardiomyopathy. J Cardiol 2009, 53:53–57.CrossRefPubMedGoogle Scholar
  37. 37.
    Abraham J, Mudd JO, Kapur NK, et al.: Stress cardiomyopathy after intravenous administration of catecholamines and beta-receptor agonists. J Am Coll Cardiol 2009, 53:1320–1325.CrossRefPubMedGoogle Scholar
  38. 38.
    Skolnick AH, Michelin K, Nayar A, et al.: Transient apical ballooning syndrome precipitated by dobutamine stress testing. Ann Intern Med 2009, 150:501–502.PubMedGoogle Scholar
  39. 39.
    From AM, Prasad A, Pellikka PA, McCully RB: Are some false-positive stress echocardiograms a forme fruste variety of apical ballooning syndrome? Am J Cardiol 2009, 103:1434–1438.CrossRefPubMedGoogle Scholar
  40. 40.
    Bybee KA, Prasad A: Stress-related cardiomyopathy syndromes. Circulation 2008, 118:397–409.CrossRefPubMedGoogle Scholar
  41. 41.
    MartÍnez-Sellés M, Datino T, Pello AM, Fernández-Avilés F: Ergonovine provocative test in Caucasian patients with left ventricular apical ballooning syndrome. Int J Cardiol 2009 Jun 10 (Epub ahead of press).Google Scholar
  42. 42.
    Citro R, Previtali M, Bovelli D, et al.: Chronobiological patterns of onset of Tako-Tsubo cardiomyopathy: a multicenter Italian Study. J Am Coll Cardiol 2009, 54:180–181.CrossRefPubMedGoogle Scholar
  43. 43.
    Yoshioka T, Hashimoto A, Tsuchihashi K, et al.: Clinical implications of midventricular obstruction and intravenous propranolol use in transient left ventricular apical ballooning (Tako-tsubo cardiomyopathy). Am Heart J 2008, 155:526–527.CrossRefPubMedGoogle Scholar
  44. 44.
    Ueyama T, Hano T, Kasamatsu K, et al.: Emotional stress induces transient left ventricular hypokinesis in the rat via activation of the cardiac adrenoceptors: a possible animal model of “tako-tsubo” cardiomyopathy. Circ J 2002, 66:712–713.CrossRefPubMedGoogle Scholar
  45. 45.
    Elesber AA, Prasad A, Lennon RJ, et al.: Four-year recurrence rate and prognosis of the apical ballooning syndrome. J Am Coll Cardiol 2007, 50:448–452.CrossRefPubMedGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2009

Authors and Affiliations

  1. 1.University of Missouri-Kansas CityOverland ParkUSA

Personalised recommendations