Pancholi P, Emami N, Fazzari MJ, Kapoor S. Stress cardiomyopathy in critical care: A case series of 109 patients. World J Crit Care Med 2022; 11(3): 149-159 [PMID: 36331975 DOI: 10.5492/wjccm.v11.i3.149]
Corresponding Author of This Article
Sumit Kapoor, MD, Division of Critical Care Medicine, Department of Medicine, Montefiore Medical Center, Bronx, NY 10467, United States. drkapoorsumit@gmail.com
Research Domain of This Article
Critical Care Medicine
Article-Type of This Article
Retrospective Study
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Parth Pancholi, Department of Medicine, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY 10467, United States
Nader Emami, Division of Critical Care Medicine, Department of Medicine, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY 10467, United States
Melissa J Fazzari, Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY 10461, United States
Sumit Kapoor, Division of Critical Care Medicine, Department of Medicine, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY 10467, United States
Author contributions: Pancholi P contributed with data acquisition, data analysis, and manuscript writing; Emami N contributed with data acquisition, analysis and manuscript editing; Fazzari MJ performed the data analysis; Kapoor S designed the study, contributed to manuscript writing, and provided overall supervision; all authors have read and approve the final manuscript.
Institutional review board statement: The study was approved by the Institutional Review Board of the Albert Einstein College of Medicine (IRB# 2019-10754) and waiver of informed consent was granted due to minimal risk.
Conflict-of-interest statement: The authors report no conflicts of interest.
Data sharing statement: Technical appendix, statistical code, and dataset available from the corresponding author. Participant consent was not obtained but the presented data are anonymized and risk of identification is low.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Sumit Kapoor, MD, Division of Critical Care Medicine, Department of Medicine, Montefiore Medical Center, Bronx, NY 10467, United States. drkapoorsumit@gmail.com
Received: November 22, 2021 Peer-review started: November 22, 2021 First decision: January 12, 2022 Revised: January 20, 2022 Accepted: March 16, 2022 Article in press: March 16, 2022 Published online: May 9, 2022
ARTICLE HIGHLIGHTS
Research background
Critically ill patients are at risk of developing stress cardiomyopathy (SC) but can be under-recognized.
Research motivation
Our goal was to learn more about patients with SC in the intensive care unit (ICU) setting.
Research objectives
To study the patient characteristics, clinical course, and outcomes of critically ill patients with SC.
Research methods
We conducted a retrospective observational study at a tertiary care teaching hospital. All adult patients admitted to the critical care units with Stress cardiomyopathy over 5 years were included.
Research results
One hundred and nine patients were identified with SC, with 55% of them in the coronary care units (CCU) and 45% in the medical-surgical intensive care units (MSICUs). 57% of patients had SC confirmed by cardiac catherization while 43% were diagnosed clinically with echocardiography. 72% of CCU patients had primary SC whereas all MSICU patients had secondary SC. 59% of MSICU patients developed shock and acute respiratory failure that required mechanical ventilation. There were no statistically significant differences in ICU mortality, in-hospital mortality, use of inotropic or mechanical circulatory support based on type of unit or anatomical variant.
Research conclusions
Primary SC was commonly seen in the CCUs while secondary SC was seen more commonly in the MSICUs. Secondary SC often presents atypically and many patients have acute respiratory failure and sepsis. Many of the SC cases in the MSICU may be diagnosed clinically as cardiac catherization is not always feasible. Patients with SC in the ICUs have excellent outcomes with the majority of them showing reversibility of cardiac function.
Research perspectives
Stress Cardiomyopathy is often under-recognized in the critical care setting. In the MSICUs, secondary SC is the main form of SC encountered, where is it is often diagnosed clinically. Routine use of Point-of-care ultrasound may help with early identification of these cases.
