Stress cardiomyopathy medical therapy

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Dima Nimri, M.D. [2]

Medical therapy in stress cardiomyopathy is indicated to treat the complications that may arise. The most common complications related to stress cardiomyopathy include heart failure and pulmonary edema. Diuretics and medications forheart failure constitute the treatment of choice in these conditions.

Medical therapy in patients with stress cardiomyopathy is mostly targeted towards the treatment of complications. For stress cardiomyopathy per se, the use of heparin and aspirin are controversial. It must be noted that the use of beta blockers alone is not advised, as this will result unopposed activity of catecholamines at the alpha receptors and can cause further prolongation of the QT interval. The combined use of alpha- and beta blockers is reasonable.^[1]

The following interventions are performed if their associated complications arise:^[1][2][3]

• Cardiogenic shock is treated with intraaortic balloon pump
• Pulmonary edema is treated by advising the patient to adopt an upright position, supplementation of oxygen, and administration of diuretics, morphine and sedatives
• Heart failure is managed ACE inhibitors, ARBs, diuretics and nitrates

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