Retrospective Study
Copyright ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Crit Care Med. May 9, 2022; 11(3): 149-159
Published online May 9, 2022. doi: 10.5492/wjccm.v11.i3.149
Stress cardiomyopathy in critical care: A case series of 109 patients
Parth Pancholi, Nader Emami, Melissa J Fazzari, Sumit Kapoor
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
Processing time: 165 Days and 15.4 Hours
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.