American Journal of Medical Case Reports
ISSN (Print): 2374-2151 ISSN (Online): 2374-216X Website: http://www.sciepub.com/journal/ajmcr Editor-in-chief: Samy, I. McFarlane
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American Journal of Medical Case Reports. 2014, 2(5), 97-101
DOI: 10.12691/ajmcr-2-5-2
Open AccessCase Report

Stress during MRI Causes Cardiomyopathy! Repeatedly! - A Case Report and Review of Pathogenesis

A. Singh1, , A. Murthy2, A. Schussheim3 and G. Lancaster4

1Arti Singh MD, Resident, Department of Internal Medicine, Bridgeport Hospital, Bridgeport, CT, USA

2Avinash Murthy MD, Fellow, Division of Cardiology, Department of Internal medicine, Bridgeport Hospital, Bridgeport, CT, USA

3Adam Schussheim MD, Clinical Cardiologist, Cardiac Specialists PC, Fairfield, CT, USA

4Gilead Lancaster MD, Director of Non-Invasive Cardiology, Division of Cardiology, Department of Internal Medicine, Bridgeport Hospital, Bridgeport, CT, USA

Pub. Date: May 28, 2014

Cite this paper:
A. Singh, A. Murthy, A. Schussheim and G. Lancaster. Stress during MRI Causes Cardiomyopathy! Repeatedly! - A Case Report and Review of Pathogenesis. American Journal of Medical Case Reports. 2014; 2(5):97-101. doi: 10.12691/ajmcr-2-5-2

Abstract

Stress cardiomyopathy is characterized by reversible wall motion abnormalities and transient systolic dysfunction in the absence of obstructive CAD or acute plaque rupture. Majority of cases involve intense emotional or physical stress triggers in post-menopausal women. Catecholamine surge, one postulated mechanism, causes acute but completely reversible myocardial dysfunction. MRI can be associated with significant stress, particularly in claustrophobic people. Our patient, with no cardiac or psychiatric history, demonstrated a stressful response to MRI developing Takotsubo cardiomyopathy (TCM) both times after the MRI in 2009 and 2013. Her anxiety likely provoked the TCM. Coronary angiography showed no obstructive disease and echocardiography showed wall motion abnormalities and systolic dysfunction, with full recovery each time confirmed on repeat echo. Patient was managed with conservative medical therapy both times. A thorough literature search failed to reveal any previously reported cases of recurrent cardiomyopathy precipitated by anxiety from MRI scan. Judicious use of anxiolytics may have averted a stressful response in our patient, perhaps preventing the development of TCM.

Keywords:
cardiovascular medicine cardiomyopathy echocardiography coronary angiography takotsubo

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