Stress cardiomyopathy (SCM) is a transient clinical condition, which mimics myocardial infarction in patients with no coronary heart disease.
Typical SCM affects the apex of the left ventricle and causes ballooning of apex. This is popularly known as “Takotsubo cardiomyopathy” or “Broken heart syndrome”. SCM wherein there is no involvement of the apical segment of the heart is called as atypical or variant SCM.
The occurrence of SCM in the perioperative period is no longer rare. It is being reported regularly even immediately prior to surgery in patients with excessive anxiety. The prevalence of SCM is estimated to be 1.2-2.2%, and the atypical SCM constitutes 40% of these cases.
Even though the aetiology of SCM is considered to be exposure to excessive levels of catecholamines in genetically susceptible individuals, the exact mechanism is not yet proven. The pathophysiology could be explained by (1)enhanced sympathetic activity originating from the central nervous system (2) catecholamine induced microvascular endothelial dysfunction or (3) coronary vasospasm.