Key result
Neurocritical illness frequently triggers stress-induced cardiomyopathy, requiring careful differentiation from acute coronary syndrome.
Why the study?
Stress-induced cardiomyopathy is increasingly recognized in critically ill patients, especially in neurological intensive care units, but diagnosis and management remain challenging due to overlap with acute coronary syndrome and limitations of invasive testing.
May warrant inclusion of stress cardiomyopathy in neuro-ICU differentials; leaves open standardized diagnostic protocols for prospective validation.
Stress-induced cardiomyopathy (SICMP) is defined as acute and transient left ventricular dysfunction that mimics acute coronary syndrome.However, it does not show significant stenosis or plaque rupture on epicardial coronary arteries.It can be precipitated by emotional or physical stress including neurological disorders such as stroke and epilepsy.The prevalence of SICMP has been increasing probably due to the fact that it is now more frequently recognized than before.The number of patients with critical illness who are at risk for SICMP is also increasing.Patients may present with symptoms indistinguishable from acute coronary syndrome or electrocardiographic (ECG) changes and cardiac enzyme elevation.Dynamic ECG changes including ST-segment elevation and diverse types of echocardiographic findings can be observed in patients with SICMP.Coronary angiography is needed to confirm the diagnosis, although it is not always possible.Therefore, diagnosing SICMP by excluding coronary artery disease is sometimes challenging.In this review, we discussed the epidemiology, precipitating conditions, clinical manifestation, differential diagnosis of SICMP, as well as proposed treatment for SICMP.
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Lee et al. (2015) conducted a review in Stress-induced cardiomyopathy. Diagnosis and management strategies was evaluated. Stress-induced cardiomyopathy is increasingly recognized in critically ill neurological patients and requires careful differential diagnosis from acute coronary syndrome, often necessitating comprehensive clinical and imaging evaluation.
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