Myocardial Stunning

OVERVIEW

• Myocardial Stunning = temporary cardiac muscle dysfunction secondary to an insult (ischaemia, hypoxia, very high afterload)
• can be focal or global

CAUSES

• post-reperfusion of a blocked coronary artery
• post-cardiac surgery
• post-cocaine OD
• post-cardiac arrest
• post-cardioversion
• in association with phaeochromocytoma

CLINICAL FEATURES

• low output state
• CCF

MANAGEMENT

• treat cause
• optimize coronary blood flow
• rest heart (decrease O2 consumption and allow muscle recovery)
• treat arrhythmias
• restore blood pressure
• fluid
• inotropes/vasoactives
• IABP
• VADs