case_images: PMC4783539_01
case_images: Initial transthoracic echocardiogram in the acute setting revealing features suggestive of stress cardiomyopathy. Systolic (a) and diastolic (b) apical 4-chamber views reveal akinetic apical and mid-anteroseptal segments (arrowheads) with hyperdynamic middle segments. Systolic (c) and diastolic (d) apical 2-chamber views disclose normal wall motion of the mid-cavity (arrows). The circumferential pattern of left ventricular myocardial dysfunction characterized by symmetric wall motion abnormalities involving the septal, anterior, and lateral walls is highly suggestive of stress cardiomyopathy.
case_images: CRICC2016-9693653.001.jpg
case_images: PMC4783539_01_CRICC2016-9693653.001.jpg
case_images: fig1
case_images: An urgent transthoracic echocardiogram revealed multiple left ventricular regional wall motion abnormalities, notably akinesis of the mid-distal anteroseptal, mid-distal anterolateral, mid-distal inferoseptal, mid-distal inferolateral, and apical segments (Figure 1).
case_images: Mean arterial pressure versus time; graph of mean arterial pressure readings against time with corresponding scheduled doses of diazepam, administration of lorazepam, infusion of dexmedetomidine, and ECG changes. *Infusion started at 11:15 AM. Does not include initial loading dose of 1 mug/kg over 10 minutes.  Infusion stopped at 11:11 AM.
case_images: CRICC2016-9693653.002.jpg
case_images: PMC4783539_01_CRICC2016-9693653.002.jpg
case_images: fig2
case_images: The mean infusion rate was 0.31 mug/kg/hr, administered over a period of 23.93 hours (Figure 2).
case_images: Repeat transthoracic echocardiogram confirming complete recovery of ventricular systolic function and resolution of the acute wall motion abnormalities, supporting the diagnosis of stress cardiomyopathy. Systolic (a) and diastolic (b) apical 4-chamber views and systolic (c) and diastolic (d) apical 2-chamber views reveal normal motion of the ventricular apex (arrows).
case_images: CRICC2016-9693653.003.jpg
case_images: PMC4783539_01_CRICC2016-9693653.003.jpg
case_images: fig3
case_images: Subsequent echocardiography performed 14 months after the event revealed resolution of the acute regional wall abnormalities and confirmed a full recovery of ventricular systolic function, further supporting the diagnosis of stress cardiomyopathy (Figure 3).