This case report highlights the association between Wellens' ECG pattern and the severity of neurogenic myocardial stunning in recurrent stress-induced cardiomyopathy.
Alerts clinicians to possible stress-related Wellens' mimics in cardiomyopathy; hypothesis-generating and should not change practice.
A 72-year-old female was diagnosed as a stress-induced cardiomyopathy from apical ballooning pattern of left ventricular dysfunction without coronary artery stenosis after the mental stress. ECG showed the transient T-wave inversions after the ST-segment elevations. By the mental stress after 1 year, she showed a transient dysfunction with similar ECG changes again. T-wave inversions recovered earlier, and cardiac sympathetic dysfunction showed a lighter response corresponding to the less severe dysfunction than those after the first onset. Wellens' ECG pattern was associated with the degree of neurogenic myocardial stunning with sympathetic hyperinnervation caused by mental stress.
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Akutsu et al. (2013) studied this question.
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