Stress-induced cardiomyopathy

Department of Cardiology, Maastricht University Hospital, Maastricht, the Netherlands.
Netherlands heart journal: monthly journal of the Netherlands Society of Cardiology and the Netherlands Heart Foundation (Impact Factor: 1.84). 10/2007; 15(9):312. DOI: 10.1007/BF03086007
Source: PubMed


Stress-induced cardiomyopathy is a relatively uncommon syndrome with difficult definition. Cases with transient and reversible
left ventricular dysfunction, precipitated by emotional stress and without coronary artery disease, are called takotsubo syndrome,
left ventricular apical ballooning, and broken heart syndrome. Many names used to refer to this syndrome are related to the
shape of the left ventricle and/or the precipitating factors, but there is not yet a consensus about the proper name. Situations
related to physical stress, such as intracranial bleeding, have similar patterns, including the absence of previous cardiac
involvement. The increased blood levels of endogenous catecholamine, and increase of myocardial catecholamine in areas with
high density of sympathetic innervations, seem to be the mechanisms for myocardial cell necrosis with eosinophilic transverse
bands. The localized spasm of the epicardial coronaries, or diffuse microcirculatory dysfunction, is also one of the proposed
mechanisms. There are still some areas of controversy that have no definite answer.

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