Acute Stress Cardiomyopathy

[Miss Sasha]

I found some interesting stuff while googling asthma, thought I would share. Sorry if this is a repeat, tried to search and got 200+ results.

Stress Cardiomyopathy Can Occur with Routine Procedures

Full Article: http://www.medpagetoday.com/Cardiology/AcuteCoronarySyndrome/13429

BALTIMORE, March 25 -- Stress cardiomyopathy, the so-called broken heart syndrome, can be precipitated by even routine procedures that involve catecholamines and beta-receptor agonists, researchers found.

Nine patients showed immediate onset of the syndrome after intravenous administration of standard doses of dobutamine (Dobutrex) for stress echocardiography and epinephrine (Adrenalin, EpiPen) under a variety of circumstances, Ilan S. Wittstein, M.D., of Johns Hopkins University, and colleagues reported online in the Journal of the American College of Cardiology.

The findings from this case series provide evidence that the effect of sudden, extreme emotional or physical stress on the heart is causally mediated by excessive sympathetic stimulation, the researchers said.

The syndrome causes profound, but reversible cardiac dysfunction that feels and looks much like a heart attack.

The characteristic clinical features include mild cardiac enzyme elevation in the absence of obstructive coronary disease, a prolonged QTc interval and diffuse T-wave abnormalities on ECG, ventricular ballooning, and rapid recovery of LV systolic function.

Since the syndrome was first described in Japan in 1991 -- where it was given the name takotsubo cardiomyopathy for the resemblance of the characteristic apical ballooning to a pot used to catch octopus -- reports have linked it to unexpected news of a death, armed robbery, and even a surprise party.

Edited October 2, 2009 by Miss Sasha

[Kiwiology]

Very interesting

[spenac]

Glad you were willing to search, seems a lost art by many. This is an interesting topic. Actually had a partner that had a patient with a patient with it a few months ago.

I did a search of site and did find a discussion but think it is worth looking more in depth at.

http://www.emtcity.com/index.php/topic/4961-2020-thursday-night-broken-heart-syndrome/page__hl__Stress%20cardiomyopathy__fromsearch__1

Nice to see a site that has educational discussions isn't it.

[Mateo_1387]

Glad you were willing to search, seems a lost art by many. This is an interesting topic. Actually had a partner that had a patient with a patient with it a few months ago.

I did a search of site and did find a discussion but think it is worth looking more in depth at.

http://www.emtcity.com/index.php/topic/4961-2020-thursday-night-broken-heart-syndrome/page__hl__Stress%20cardiomyopathy__fromsearch__1

Nice to see a site that has educational discussions isn't it.

I am glad you were willing to proof read your post. It seems to be a lost art.

[cosgrojo]

I recently transported someone with tako-tsubo syndrome. I obviously did not know what it was at the time. The call came in as a life-line (fallen and can't get up buttons) activation, that my dispatchers treat as BLS response criteria. Luckily the patient had a print out about what it is, because she couldn't explain it. She was c/o nausea/vomiting... no acute distress upon our arrival. It was my partner's tech and he went about the business of interviewing the patient and getting vitals and all that. I was reading the material and getting medical history and the med lists...

Based on his assessment, my partner was treating it very BLS... He got her on the stretcher as I started reading the handout. We got half way out of the building as I got far enough into the pamphlet that I started to worry. This could go bad, and it could got bad fast. While the majority of people with this syndrome live a long, uncomplicated life after the first attack, and rarely have another one... when they do... they don't do so well. By the time I realized how bad this could go, we were far closer to the hospital than our ALS counterparts. And the last thing I wanted to do was increase the anxiety on this lady.

Based on what my partner gave for a report to the hospital, they were going to put us in an over-flow room (I do not blame my partner... how was he to know? I had the info, and I didn't want to raise the warning bells because of the possible anxiety). I quickly corrected this so that we could deposit into an acute telemetry room. Within 15 minutes of putting our perfectly normal looking, non distressed patient on the ER bed, she was unresponsive on the bed with her eyes rolled back, body rigid as a board. I got another call right after that and did not get a chance to follow up on her.

Scary...

[spenac]

I am glad you were willing to proof read your post. It seems to be a lost art.

Whats that mean?