The data studied include Regional Wall Motion Abnormality
suggestive of ischemia (RWMA), LV and RV chamber dimensions, LV ejection fraction, mitral regurgitation, LV clot, pulmonary hypertension, tricuspid regurgitation, RV function, pericardial effusion, identification of ventricular septal rupture and ventricular aneurysm.
TTE revealed normal left ventricular systolic function with no wall motion abnormality
. In view of acute symptoms and positive troponin I, cardiac computed tomographic angiography (CTA) was performed which showed normal coronary arteries.
Patients underwent echocardiography to record remote regional wall motion abnormality
. Patients were observed during period of hospitalization for mortality.
The first abnormality induced by epicardial ischemia is reduced ventricular compliance, not wall motion abnormality
, ECG changes, or chest pain .
Her transthoracic echocardiogram revealed normal LV size and systolic function with no regional wall motion abnormality
. Clozapine-induced myocarditis was suspected; however, a cardiac magnetic resonance scan showed no late gadolinium enhancement or increased signal intensity on T1- and T2-weighted images to suggest myocarditis.
The infusion is stopped when 85% of the maximal heart rate is achieved, new or worsening wall motion abnormality
develops in 1 or greater LV segments, BP increases to greater than 240/20mmHg or SBP drops >40mmHg, or if the patient develops adverse symptoms or persistent arrhythmias.
Resolution of her episode of SIC was defined by a repeat echocardiogram showing EF of 60% without identifiable wall motion abnormality
(Figure 1, preoperative TTE, end diastole).
Acute coronary syndrome referred to patients who fulfilled the third universal definition criteria of elevated cardiac biomarkers of at least one value above the 99th percentile upper reference limit and one of the following: symptoms of ischemia, development of pathologic Q waves in the electrocardiogram, new or presumed new significant ST-segment-T-wave (ST-T) changes or new left bundle branch block (LBBB), and imaging evidence of new loss of viable myocardium or a new regional wall motion abnormality
. We excluded the patients with age < 18 years, patients with intracerebral hemorrhage, subarachnoid hemorrhage, hemorrhagic contusions, epidural hemorrhage, subdural hemorrhage, and other brain lesions, and patients with end stage renal disease on hemodialysis.
These records included the following: (1) The available medical data, including body mass index (BMI), combined diseases, infarction location, length of duration before hospital admission, ventricular fibrillation, and urgent revascularization (which included anticoagulation, PPCI, and coronary artery bypass grafting [CABG]); and (2) records of echocardiography, including left ventricular ejection fraction (LVEF), regional wall motion abnormality
(RWMA), mitral regurgitation (MR), pericardial effusion, and left ventricular aneurysm.
They did serial ECHOs with a PD exchange, and found a very low occurrence of regional wall motion abnormalities, (only one patient had more than one regional wall motion abnormality
, six had none).
Investigations and Progress: Echocardiography revealed normal sized cardiac chambers, no segmented wall motion abnormality
, good left ventricular systolic function with ejection fraction of 60%, grade 1 diastolic dysfunction and normal heart valves.
We report a forme fruste of stress cardiomyopathy without regional wall motion abnormality
and high troponin-ejection fraction product.