Haynor J, Colombo C, Javaheri S. A Novel Approach to the Diagnosis of Stress-Induced Cardiomyopathy. J Am Osteopath Assoc 2012;112(11):743-747. doi: 10.7556/jaoa.2012.112.11.743.
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Stress-induced cardiomyopathy is becoming a more commonly recognized diagnosis, accounting for 2% to 3% of patients presenting with signs and symptoms of acute anterior myocardial infarction. We present the case of a 68-year-old man with dyspnea 9 days after an unrelated operation. After hospital admission, he complained of chest pain, and an electrocardiogram demonstrated ST-segment elevation in the anterolateral and inferior leads, ST-segment depression in lead aVR, and an absence of ST-segment changes in lead V1. Cardiac biomarker levels were elevated. Transthoracic echocardiography demonstrated a left ventricular ejection fraction of 30% to 40%, basilar hyperactivity, apical dyskinesia, and distal inferior and anterior akinesia. Cardiac catheterization did not reveal any culprit obstructive lesion. He received a diagnosis of stress-induced cardiomyopathy and was treated according to established recommendations for systolic heart failure. His cardiac biomarkers returned to normal, and a repeated transthoracic echocardiogram 3 days later revealed nearly complete resolution of myocardial wall–motion abnormalities.
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