Stress-induced cardiomyopathy can present as transient global left ventricular dysfunction, suggesting that classic takotsubo syndrome with regional wall motion abnormalities is only part of the spectrum of this condition.
Global LV dysfunction may occur in stress cardiomyopathy; extends takotsubo spectrum but leaves open confirmation in larger studies.
The diagnosis of stress-induced cardiomyopathy requires wall motion abnormality, most typically apical ballooning. The authors report 3 cases of transient global left ventricular systolic dysfunction that developed over the course of severe medical illnesses. The cardiomyopathy that developed in each patient had all the features of takotsubo cardiomyopathy, including reversibility, mild troponin elevation, nonspecific electrocardiographic abnormalities, and a negative work-up for ischemia. The only difference was the absence of regional wall motion abnormalities. No patients developed sepsis or myocarditis. Stress-induced cardiomyopathy may present in different forms, including regional or global left ventricular dysfunction. Classic takotsubo syndrome may represent only part of the spectrum of this reversible condition.
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Win et al. (2011) studied this question.
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