Discussion
SC triggered by nervous system disease has been described in multiple
reports. The relationship between both entities is still not clear. A
systematic review conducted by Porto et al. in 2013 of 124 reported
cases concluded that this entity involves the cardiac apex more
frequently and is more common among women. The seizure was the
associated nervous system disease in 1.8% of cases, of which only 5.6%
were males and 72.2 % of cases had the typical apical type of SC.
Cardiac Magnetic Resonance Imaging is a well-established imaging
modality that helps in assessing the functional and tissue properties of
the heart. It can non-invasively distinguish stress cardiomyopathy
syndrome from other conditions such as myocardial infarction,
myocarditis, or myocardial infiltrative disease. The involvement of the
right ventricle in this syndrome which is found in almost one-third of
the cases was reported only through cardiac MRI. The MRI data from the
study conducted by Leurent et al. showed that the pathogenesis in SC is
neither ischemic nor fibrotic as the delayed gadolinium enhancement is
almost never found in these patients. Stress cardiomyopathy is a
diagnosis of exclusion. In our patient, the cardiac MRI confirmed the
wall motion abnormalities and helped in the exclusion of other possible
differentials.