Recurrent stress cardiomyopathy with different electrocardiographic abnormalities on each presentation in a depressed post-menopausal woman

J Cardiol Cases. 2013 Jan 17;7(4):e104-e108. doi: 10.1016/j.jccase.2012.12.002. eCollection 2013 Apr.

Abstract

Stress cardiomyopathy (SCM) is a syndrome of transient cardiac abnormalities precipitated by intense emotional or physical stress. Differentiating SCM from acute myocardial infarction is often difficult but vital to avoid subjecting SCM patients to unnecessary reperfusion therapy and invasive coronary angiography. For accurate diagnosis, it is important that physicians be familiar with the current diagnostic criteria, most susceptible populations, and typical triggers for SCM. SCM occurs almost exclusively in post-menopausal women, a group with a high frequency of psychiatric disorders. Thus, in addition to typical trigger events, comorbid psychiatric disorders may contribute to SCM onset. We report a rare case of recurrent SCM with distinct electrocardiographic abnormalities during each presentation in a post-menopausal woman with depression. <Learning objective: Recurrence of SCM was thought to be infrequent before but it has been increasingly reported recently. Although the underlying mechanism remains unclear, comorbid psychiatric disorders may contribute significantly to the pathogenesis of SCM and its influence may have been underestimated. Routine mental health screening should be done accompanying therapy for SCM.>.

Keywords: Apical ballooning syndrome; Depression; Stress cardiomyopathy; Takotsubo cardiomyopathy.