Published online May 9, 2022. doi: 10.5492/wjccm.v11.i3.149
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
Processing time: 165 Days and 15.4 Hours
Critically ill patients are at risk of developing stress cardiomyopathy (SC) but can be under-recognized.
Our goal was to learn more about patients with SC in the intensive care unit (ICU) setting.
To study the patient characteristics, clinical course, and outcomes of critically ill patients with SC.
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.
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.
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.
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.