Abstract 13635: Isolated Right Ventricular Stress Cardiomyopathy: A Systematic Review of Literature

Abstract

Background: Takotsubo Cardiomyopathy (TTC), also known as stress cardiomyopathy, is characterized by transient systolic and diastolic dysfunction without evidence of significant coronary artery stenosis. In 2012, TTC attributed to about 0.02% of hospitalizations in the United states, largely seen in the elderly female population. Although it primarily affects the left ventricle, there are different variant patterns documented mostly affecting younger individuals. Here we present a systematic review of right ventricle TTC. Methods: On January 7th, 20221, a systematic search without limitation in the time frame was conducted using Pubmed, Google Scholar, CINAHL, Cochrane CENTRAL, and Web of Science databases and a total of 9 cases were identified (1 case was excluded due to duplicity). Results: The mean age of the patients listed was 65.2 ± 23.35 with majority (8/9) 88% of patients being women. Commonest presentation was dyspnea (67%), followed by chest pain (22%), nonspecific discomfort in 11%, and acute heart failure in 11%. Cardiogenic shock was reported in 56% of the cases. Management and treatment included inotropic or vasopressor support in 67% of the cases and 11% requiring venoarterial extracorporeal membrane oxygenation (V-A ECMO). Improvement of right ventricular function was reported in all but 1 patient who died. Conclusion: Isolated right ventricular stress cardiomyopathy is rare but possibly underreported. Though associated with a higher incidence of cardiogenic shock on presentation than traditional stress cardiomyopathy, they do seem to spontaneously recover once out of the acute phase of the syndrome as noted in our study. While the pathogenesis of stress cardiomyopathy is still not fully understood, genetic predispositions may be involved. Current recommendations for management include conventional heart failure medications including beta blockers, ACE inhibitors and diuretics despite limited evidence.