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Table 18. Special Patient Groups (cont'd)
Recommendations
COR LOE
Stress (Takotsubo) cardiomyopathy
Stress (Takotsubo) cardiomyopathy should be considered in
patients who present with apparent ACS and nonobstructive
CAD at angiography.
I C
Imaging with ventriculography, echocardiography, or magnetic
resonance imaging should be performed to confirm or exclude the
diagnosis of stress (Takotsubo) cardiomyopathy.
I B
Patients should be treated with conventional agents (ACE
inhibitors, beta blockers, ASA, and diuretics) as otherwise
indicated if hemodynamically stable.
I C
Anticoagulation should be administered in patients who develop
LV thrombi.
I C
It is reasonable to use catecholamines for patients with symptomatic
hypotension if outflow tract obstruction is not present.
IIa C
e use of an intra-aortic balloon pump is reasonable for patients
with refractory shock.
IIa C
It is reasonable to use beta blockers and alpha-adrenergic agents in
patients with outflow tract obstruction.
IIa C
Prophylactic anticoagulation may be considered to inhibit the
development of LV thrombi.
IIb C
