Stress Cardiomyopathy: The Daily PANCE Blueprint

The answer is B. Older females after emotional or physical stress

Stress cardiomyopathy (takotsubo cardiomyopathy) typically presents as acute transient LV dysfunction. It most often mimics acute coronary syndrome, but there is no actual obstructive coronary disease. Emotional or physical stress usually triggers it, often in older females. Clinical features include: chest pain, dyspnea, EKG changes (ST elevations or T wave inversions). An echocardiogram will show a decline in the left ventricular function with wall motion abnormalities. The classic finding is apical ballooning (see next slide). Management is typically supportive (guideline-directed medical therapy if they are not in cardiogenic shock), inotropes and vasopressors if they are in cardiogenic shock, and if refractory, then mechanical circulatory support.