Diagnosis and Management of Stress-induced Cardiomyopathy in Neurological Intensive Care Units

So-Ryoung Lee, Yeonyee E. Yoon
2015 Journal of Neurocritical Care  
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
more » ... 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. J Neurocrit Care 2015;8(1):1-8
doi:10.18700/jnc.2015.8.1.1 fatcat:nzlhshwpa5hmdcqgoeuy4wdajq