Title: Stress Cardiomyopathy: Emerging concepts on diagnosis and management

Biography:

Samer Ellahham has served as Chief Quality Officer for SKMC since 2009. In his role, Dr. Ellahham has led the development of a quality and safety program that has been highly successful and visible and has been recognized internationally by a number of awards. As Chief Quality Officer and Global Healthcare Leader, Dr. Ellahham had a focus on ensuring that that implementation of these best practices leads to breakthrough improvements in clinical quality, patient safety, patient experience and risk management. Dr. Ellahham is a Board-certified internist, cardiologist and vascular medicine senior consultant and continues to care for patients. He received his undergraduate degree in biology and his M.D. from the American University of Beirut, Beirut, Lebanon.

Abstract

Stress cardiomyopathy, takotsubo cardiomyopathy, is a syndrome characterized by transient regional left ventricular dysfunction in the absence of significant coronary artery disease. Possible pathogenic mechanisms include catecholamine excess, microvascular dysfunction, and multivessel coronary artery spasm. The diagnosis should be suspected in adults who present with a suspected acute coronary syndrome when the clinical manifestations are out of proportion to the degree of elevation in cardiac biomarkers. A physical or emotional trigger is often but not always present. Wall motion abnormalities in patients with stress cardiomyopathy are typically the apical type, and atypical variants including mid-ventricular, basal, focal, and global types. The differential diagnosis of stress cardiomyopathy includes acute coronary syndromes, coronary artery spasm, myocarditis, and pheochromocytoma. A high index of suspicion is key in the diagnosis and management.