Electrocardiographic pattern combined with echocardiographic wall motion abnormalities in stress related cardiomyopathies: clinical and pathophysiological insights
Título del documento: Electrocardiographic pattern combined with echocardiographic wall motion abnormalities in stress related cardiomyopathies: clinical and pathophysiological insights
Revue: Archivos de cardiología de México
Base de datos: PERIÓDICA
Número de sistema: 000351472
ISSN: 1405-9940
Autores: 1
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Instituciones: 1Ospedale Brescia, Unidad de Cardiología, Milán, Lombardia. Italia
Año:
Periodo: Ene-Mar
Volumen: 82
Número: 1
Paginación: 22-30
País: México
Idioma: Inglés
Tipo de documento: Artículo
Enfoque: Caso clínico, analítico
Resumen en español ecocardiograma de estrés puede ser propuesto a pacientes en los cuales permanece la sospecha de enfermedades coronarias
Resumen en inglés We report five cases of stress related cardiomyopahies that occurred in post-menopausal women (age range from 49 to 90) consecutively admitted to our Department in the last year in different clinical settings: typical anginal pain, carotid endarterectomy, pulmonary edema, cardiogenic shock, and severe asthenia. Apical left ventricular involvement was observed in three patients in conjunction with ECG mild ST segment elevation in anterior precordial leads resembling acute anterior myocardial infarction; isolated mid ventricular dysfunction was present in two patients in conjunction with ST segment depression in the anterior precordial leads. The ECG evolved showing T wave inversion in four cases and normalized in one. In all cases, blood chemistry showed mild elevation of CK-MB and TN. The observed wall motion abnormalities were reversible in four of five cases during hospital stay. Stress echocardiography was performed in two patients (dobutamine in the patient with persistent mid-ventricular hypokinesis, exercise in another case) and correctly predicted the absence of coronary artery disease. We conclude that wall motion analysis at echocardiography combined with ECG ST segment changes and serum markers of myocardial necrosis (CK-MB and TN) may allow recognition of stress cardiomyopathies in different clinical settings. Echo stress may be proposed in those patients in whom some suspicion of coronary artery disease persists
Disciplinas: Medicina
Palabras clave: Diagnóstico,
Sistema cardiovascular,
Estrés,
Cardiomiopatías,
Síndrome coronario agudo,
Ecocardiograma
Keyword: Medicine,
Cardiovascular system,
Diagnosis,
Stress,
Myocardiopathy,
Acute coronary syndrome,
Echocardiogram
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