Korean Circ J.  2007 Aug;37(8):388-392. 10.4070/kcj.2007.37.8.388.

A Case of Stress-Induced Cardiomyopathy Related with the Postpartum Period

• Jeon JH
• Her SH
• Lee JM
• Yoon HJ
• Chin JY
• Park KH
• Won KY
• Jie BS
• Park YR
• Jin SW

• KMID: 2029068
• DOI: http://doi.org/10.4070/kcj.2007.37.8.388

Abstract

Stress-induced cardiomyopathy is a relatively rare, unique entity that has only recently been widely appreciated. It characterized by transient left ventricular regional wall motion abnormalities (with a peculiar apical ballooning appearance), chest pain or dyspnea, ST-segment elevation and/or T wave inversion and minor elevations of the cardiac enzyme levels. The patients in the previous series were usually women over 50 years of age and a triggering event was identified in most cases; these included severe emotional distress or an acute medical illness. Although reports of single episodes of stress-induced cardiomyopathy are not infrequent in the recent medical literature, we report here on a case of stress-induced cardiomyopathy in a young women, and this was related with the post-partum period as a stressful condition.

Keyword

Cardiomyopathies; Stress; Postpartum period

MeSH Terms

Cardiomyopathies*
Chest Pain
Dyspnea
Female
Humans
Postpartum Period*

Figure

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  Fig. 1 Electrocardiogram in the primary clinic and the EMS ambulance before admission. A: the twelve-lead electrocardiogram done at the primary clinic revealed a normal sinus rhythm and a normal QT interval (corrected QT interval: 0.430 second). B: the rhythm strip demonstrating ventricular fibrillation. C: the rhythm strip taken during defibrillation by the EMS team. EMS: emergency medical service.

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  Fig. 2 The twelve-lead electrocardiogram obtained upon admission (post-resuscitation) depicts mild ST segment elevation in the II, III and aVF leads and in the V1-V6 leads.

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  Fig. 3 Echocardiography depicts the reversible apical wall motion abnormality. A: the echocardiogram obtained upon admission depicts hyperkinesis of the basal segments, which was observed via the M-mode. B: hypokinesis of the mid-portion of the left ventricle was observed. C: hypokinesis of the apex was observed. D: echocardiograms taken 14 days after admission showed no interval change of the basal segment. E: improvement of the mid-ventricular wall motion was observed on the follow up echocardiograms. F: improvement of the apical wall motion is demonstrated.

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  Fig. 4 A: the left coronary artery in the cranial right anterior oblique and caudal views showing the coronary arteries with no obstructive lesions. B: a spasm provoked by ergonovine was observed in the left anterior descending artery. C: it was relieved by nitroglycerin.

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  Fig. 5 Representative left ventriculogram from the patient: images obtained in diastole (A) and systole (B). Left ventriculography revealed akinesis of the left ventricular apex and the mid-portion.

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