The symptoms do mimic a heart attack, said Dr. James Januzzi, a trustee with the American College of Cardiology and a cardiologist at Massachusetts General Hospital in Boston.
But as tests are done, he said, the true cause grows clearer.
For one, Januzzi explained, stress cardiomyopathy looks different from a heart attack on electrocardiogram, which measures the heart’s electrical activity. And when doctors do an angiogram to peer inside the heart arteries, they’ll find no blockages in a patient with stress cardiomyopathy.
The good news, Januzzi said, is that people with the condition typically recover quickly, with no long-term heart damage.
Kass said that given all the stresses of the pandemic — from fear of the virus to job losses to social isolation — it’s not hard to imagine why stress cardiomyopathy would increase.
But he also sounded a note of caution on the findings: From the start of the pandemic, many U.S. hospitals saw a significant drop in heart attack patients — possibly because people feared a trip to the ER and were not calling 911.
And that, Kass said, could be one reason why the percentage of stress cardiomyopathy diagnoses rose.
“The denominator has changed,” he said. “So it’s hard to know whether this is actually happening a lot.”
Januzzi agreed that could be a factor.
What’s interesting, he said, is that none of the patients tested positive for COVID-19. Cases of “COVID-associated” stress cardiomyopathy have been reported in patients with the infection, Januzzi noted, but cases associated with the pandemic itself would be new.
And it’s “very plausible,” he said, that these stressful times could be leading to a true increase in the condition.
For the general public, Januzzi said, it’s critical to act on symptoms of chest pain and difficulty breathing: Get to the ER and let doctors diagnose it.
Kalra agreed. He also urged people to do their best to manage stress — getting regular exercise, for example, or using meditation to quiet the mind.
The findings were published online July 9 in JAMA Network Open.
WebMD News from HealthDay
SOURCES: Ankur Kalra, MD, interventional cardiologist, Cleveland Clinic, Ohio; David Kass, MD, professor, cardiology, Johns Hopkins University School of Medicine, Baltimore; James Januzzi, MD, trustee, American College of Cardiology, cardiologist, Massachusetts General Hospital, and professor, medicine, Harvard Medical School, Boston;JAMA Network Open, July 9, 2020, online
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