Chest
Clinical InvestigationsReversible Myocardial Contraction Abnormalities in Patients With an Acute Noncardiac Illness
Section snippets
Materials and Methods
Between 1993 and 1996, we identified 22 patients who shared the following characteristics: (1) hospitalization for an acute noncardiac illness; (2) appearance of deep (≥3.0 mm) T-wave inversion in the precordial leads of the ECG (Fig 1); and (3) presence of a presumed new anterior contraction abnormality on an echocardiogram. All patients were identified as a consequence of a request for cardiac consultation by the medicine or surgery service. Data were primarily collected retrospectively and
Patient Characteristics
The study group comprised 22 acutely ill patients. The baseline characteristics of these patients are presented in Table 1. The average age was 56.3 years (range, 19 to 83 years) and 18 patients (82%) were women. Each patient was hospitalized with an acute noncardiac illness (Table 1). The primary diagnoses included CNS injury (n=6); sepsis (n = 3); acute pulmonary disease (n=3); drug overdose or metabolic abnormality (n=7); and post noncardiac surgery (n=3). Cocaine use was not a factor in any
Discussion
This study describes the occurrence of prolonged but reversible anterior-apical contraction abnormalities in critically ill patients. None of the patients was hospitalized because of a primary cardiac illness. The cardiac injury observed in these patients shares many similarities with the phenomenon of myocardial stunning. First, the injury was regional. Second, there was significant improvement of regional wall motion over a period of days. In most patients, complete recovery of regional wall
Addendum
Since this manuscript was submitted, Parin et al24 have reported two cases of transient cardiomyopathy triggered by intense emotional stress. The clinical features and ECG findings reported are similar to those described herein.
Acknowledgments
Rosie Robinson, MaryAnn Murakami, and Maureen Adams are responsible for expert preparation of this manuscript. We thank Dr. Howard Burchell for his encouragement and interest in this report.
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