Myocardial stunning pattern' in ECG, which mimics myocardial infarction?
(A) Takotsubo cardiomyopathy[?]"Myocardial Stunning" is a condition where certain segments of myocardium (corresponding to area of major coronary occlusion) shows forms of contractile abnormality.oSegmental dysfunction persisting for a variable period of time, about 2 weeks, even after ischemia has been relieved (by for Instance Angioplasty or Coronary Artery Bypass Surgery).oTakotsubo cardiomyopathy or Takotsubo syndrome, is a temporary condition where the heart muscle becomes suddenly weakened or 'stunned'.oSymptoms of Takotsubo (stress-related) cardiomyopathy often start abruptly with chest pain & shortness of breath.oThis cardiomyopathy, is triggered by an emotionally or physically stressful event & may mimic acute MI.oAssociated ECG abnormalities: ST-segment elevation & elevated biomarkers of myocardial injury.Other Options[?]Restrictive Cardiomyopathy:-It is dominated by abnormal diastolic function, often with mildly decreased contractility & ejection fraction (usually >30-50%).-Seen in Amyloidosis, sarcoidosis, hemochromatosis etc.,-Ventricles become rigid & lack the flexibility to expand during diastole.-SOB, fatigue, palpitations & syncope.-Other Common Findings: Atrial fibrilation, conduction delays.-ECG shows Low voltage, non-specific ST-T wave abnormalities & various arrhythmias.[?]Brugada byndrome:-ECG shows >0.2mV of ST-segment elevation with coved ST segment & negative T wave in more than one anterior precordial lead (V1 -V3 ) and episodes of syncope or cardiac arrest due to polymorphic VT in the absence of structural heart disease.-Cardiac arrest may occur during sleep or be provoked by febrile illness.-Males are more commonly affected than females.-Quinidine used successfully to suppress frequent episodes of VT[?]Pericardial Effusion:oClassical triad of findings for pericardial effusionowith cardiac tamponade:-Sinus tachycardia,-Low QRS voltage,-Electrical alternans (Best seen in V3 & V4 )
Takotsubo cardiomyopathy
Restrictive cardiomyopathy
Brugada Syndrome
Pericardial effusion
C.V.S.