Stress cardiomyopathy refers to catecholamine-induced myocardial injury that results in transient left ventricular systolic dysfunction. There are two recognized varieties of stress cardiomyopathy: (1) that caused by acute emotional or physical stress (Takotsubo cardiomyopathy or apical ballooning syndrome), and (2) that associated with catecholamine release secondary to central nervous system trauma (socalled neurogenic stress cardiomyopathy).

Takotsubo cardiomyopathy, originally described in the early 1990s, refers to a type of stress cardiomyopathy characterized by acute but rapidly reversible left ventricular systolic dysfunction in the absence of atherosclerotic coronary artery disease, triggered by profound psychological stress.¹ Neurogenic stress cardiomyopathy, described nearly a decade later, is also mediated by catecholamineinduced myocardial injury but is the result of CNS injury (such as head trauma or cerebral infarction.^2,3,4,5 Although some consider both stress cardiomyopathy and neurogenic cardiomyopathy part of the same disease,⁵ there are characteristics that separate the two (Table 161.1).

Although there is overlap with takotsubo cardiomyopathy,⁸ neurogenic stress cardiomyopathy is generally reserved for patients with cardiac dysfunction related to head trauma or cerebral infarction.