COVID-19-associated stress cardiomyopathy differential diagnosis: Difference between revisions

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Revision as of 20:41, 18 July 2020

link=https://www.wikidoc.org/index.php/COVID-19-associated stress cardiomyopathy
link=https://www.wikidoc.org/index.php/COVID-19-associated stress cardiomyopathy

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: José Eduardo Riceto Loyola Junior, M.D.[2]

Overview

COVID-19-associated stress cardiomyopathy must be differentiated from other diseases that cause left ventricular dysfunction such as acute myocardial infarction (STEMI and NSTEMI) and viral myocarditis.

Differential Diagnosis

Disease Can Present With Cardiac Enzymes Catecholamine Levels ECG Findings Echocardiography Findings Prognosis
Stress Cardiomyopathy Chest pain, dyspnea Transiently elevated ST elevation in precordial leads LV regional dysfunction Very good
Pheochromocytoma Chest pain, dyspnea Can be positive Persistently elevated ST elevation in precordial leads LV regional dysfunction Good to poor - it varies if disease is localized or diffuse (95% to 50% survival in 5 years)[1]
Anterior MI Chest pain, dyspnea ↑↑↑ - ST elevation in precordial leads Dysfunction at area of infarction Variable - depends on the coronary lesion, but usually it has a 30% mortality rate and 5-10% of the survivors die within one year of the event[2]
Myocarditis Chest pain, dyspnea, fever May be acutely elevated - May show atrial fibrillation, LBBB or AV block Diffuse hypokinesia Extremely variable
Dilated Cardiomyopathy Dyspnea, dyspnea on exertion, cough, edema, fatigue Usually negative - May show atrial fibrillation, LBBB or AV block LV enlargement Poor - survival is less than 50% in ten years[3]
Hypertrophic Cardiomyopathy Chest pain, dyspnea, syncope, sudden cardiac death Usually negative - Common findings include: LV hypertrophy, systolic anterior motion of the mitral valve, asymmetric septal hypertrophy Generably good with up to 2/3 of the patients having a normal life, and a 1% cardiac annual mortality[4]
COVID-19-associated Stress Cardiomyopathy Chest pain, dyspnea Transiently elevated ST elevation in precordial leads LV regional dysfunction Very good - but hospitalizations may be longer in comparison to regular stress cardiomyopathy[5]

References

  1. "Cancer.net - Statistics of Pheochromocytoma and Paraganglioma". Cancer.net. 07/18/2020. Check date values in: |date= (help)
  2. "Medscape - Acute MI". Medscape. 07/18/2020. Check date values in: |date= (help)
  3. "Medscape - Dilated Cardiomyopathy". Medscape. 07/18/2020. Check date values in: |date= (help)
  4. Ten Cate FJ (1996). "Prognosis of hypertrophic cardiomyopathy". J Insur Med. 28 (1): 42–5. PMID 10163618.