Stress cardiomyopathy causes

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Dima Nimri, M.D. [2] Arzu Kalayci, M.D. [3]

Stress cardiomyopathy Microchapters



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Differentiating Stress Cardiomyopathy from other Diseases

Epidemiology and Demographics

Risk Factors


Natural History, Complications and Prognosis


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Cost-Effectiveness of Therapy

Unstable angina/non ST elevation myocardial infarction in Stress (Takotsubo) Cardiomyopathy

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Case #1

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The cause of stress cardiomyopathy is largely unknown. However, it is usually triggered by emotional and/or physical stress and may be related to certain medical conditions. According to a study in the literature, plasma catecholamine levels were higher in patients with stress cardiomyopathy compared to the patients with myocardial infarction. However, other studies showed that catecholamine levels were similar in both groups. [1] In addition stress cardiomyopathy can be induced by high doses of catecholamines and even standard doses of dobutamine in daily clinical practise. [2] [3] It is not understood why the disease mostly affects postmenopausal women and why the apex and mid-ventricular part of left ventricle are specifically affected.


The cause of stress cardiomyopathy is unknown. However, stress cardiomyopathy can result from various medical conditions including:[4][5][6]


  1. Madhavan M, Borlaug BA, Lerman A, Rihal CS, Prasad A (2009). "Stress hormone and circulating biomarker profile of apical ballooning syndrome (Takotsubo cardiomyopathy): insights into the clinical significance of B-type natriuretic peptide and troponin levels". Heart. 95 (17): 1436–41. doi:10.1136/hrt.2009.170399. PMID 19468013.
  2. Sharkey SW, Windenburg DC, Lesser JR, Maron MS, Hauser RG, Lesser JN; et al. (2010). "Natural history and expansive clinical profile of stress (tako-tsubo) cardiomyopathy". J Am Coll Cardiol. 55 (4): 333–41. doi:10.1016/j.jacc.2009.08.057. PMID 20117439.
  3. Abraham J, Mudd JO, Kapur NK, Kapur N, Klein K, Champion HC; et al. (2009). "Stress cardiomyopathy after intravenous administration of catecholamines and beta-receptor agonists". J Am Coll Cardiol. 53 (15): 1320–5. doi:10.1016/j.jacc.2009.02.020. PMID 19358948.
  4. Kotsiou OS, Douras A, Makris D, Mpaka N, Gourgoulianis KI (2017). "Takotsubo cardiomyopathy: a known unknown foe of asthma". J Asthma: 0. doi:10.1080/02770903.2016.1276586. PMID 28055270.
  5. Gill D, Liu K (2016). "Takotsubo cardiomyopathy associated with Miller-Fisher syndrome". Am J Emerg Med. doi:10.1016/j.ajem.2016.12.050. PMID 28040387.
  6. Murdoch D, O'Callaghan W, Reda E, Niranjan S (2016). "Takotsubo Cardiomyopathy Associated with Primary Hyperthyroidism Secondary to Toxic Multinodular Goiter". Int J Angiol. 25 (5): e121–e122. doi:10.1055/s-0035-1548548. PMC 5186230. PMID 28031674.

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