Myocardial Stunning (मायोकार्डियल स्टनिंग) एक reversible cardiac condition है जिसमें temporary loss of myocardial contractile function होती है।
- यह heart tissue ischemia (oxygen deficiency) के बाद होता है।
- Despite restoration of blood flow, heart muscle temporarily weak रहता है।
- Commonly seen after acute myocardial infarction (heart attack), cardiac surgery, or reperfusion therapy।
- Unlike myocardial necrosis, cells remain alive और function कुछ समय में recover हो जाती है।
Myocardial Stunning क्या है (What is Myocardial Stunning)
- Temporary left ventricular dysfunction
- Occurs after ischemia and reperfusion
- Characterized by reduced contractility, normal blood flow, and viable myocardium
- Can contribute to acute heart failure, low cardiac output, or arrhythmias
Myocardial Stunning कारण (Causes of Myocardial Stunning)
1. Acute Myocardial Infarction (Heart Attack)
- Temporary ischemia during infarction
- Reperfusion (angioplasty or thrombolysis) triggers stunning
2. Cardiac Surgery / Procedures
- Cardiopulmonary bypass
- Valve replacement or repair
3. Transient Coronary Occlusion
- Vasospasm or microvascular obstruction
4. Other Causes
- Takotsubo cardiomyopathy (stress-induced)
- Severe hypotension or shock
- Sepsis-related myocardial dysfunction
Myocardial Stunning लक्षण (Symptoms of Myocardial Stunning)
- Chest discomfort or pain (if post-ischemia)
- Shortness of breath (dyspnea)
- Fatigue and reduced exercise tolerance
- Low cardiac output symptoms: hypotension, dizziness
- Rarely, arrhythmias or heart failure symptoms
Symptoms depend on extent of myocardial involvement।
Myocardial Stunning कैसे पहचाने (Diagnosis of Myocardial Stunning)
- Echocardiography – shows regional wall motion abnormalities despite patent coronary arteries
- Electrocardiogram (ECG) – may show ischemic changes or ST-T changes
- Cardiac Biomarkers – troponin may rise if ischemia occurred, but necrosis absent
- Coronary Angiography – rule out obstructive lesions
- Cardiac MRI – identifies viable myocardium and reversible injury
Diagnosis is often post-reperfusion evaluation।
Myocardial Stunning इलाज (Treatment of Myocardial Stunning)
1. Supportive Cardiac Care
- Oxygen therapy
- Blood pressure and heart rate management
- Avoid additional ischemic episodes
2. Medications
- Beta-blockers – reduce myocardial oxygen demand
- ACE inhibitors / ARBs – improve cardiac remodeling and function
- Diuretics – if fluid overload or heart failure
3. Revascularization (if needed)
- PCI (Percutaneous Coronary Intervention)
- CABG (Coronary Artery Bypass Graft) for underlying obstructive disease
4. Monitoring
- Serial echocardiography to track recovery of myocardial function
- ECG and biomarkers monitoring
Most cases recover within days to weeks, full function restored gradually।
रोकथाम (Prevention)
- Timely treatment of acute coronary syndromes
- Avoid prolonged myocardial ischemia
- Control risk factors: hypertension, diabetes, smoking, hyperlipidemia
- Regular cardiac check-ups in high-risk patients
सावधानियाँ (Precautions)
- Early recognition of chest pain and ischemic symptoms
- Avoid sudden strenuous activity immediately post-MI
- Follow cardiac medications as prescribed
- Report new symptoms like dyspnea, chest pain, palpitations
FAQs (अक्सर पूछे जाने वाले प्रश्न)
Q1. Myocardial stunning permanent है या temporary?
यह usually temporary होती है, और heart function days to weeks में recover कर जाता है।
Q2. क्या इसे heart attack समझा जा सकता है?
यह ischemic injury का result हो सकता है, लेकिन cell death (necrosis) नहीं होती, इसलिए यह heart attack नहीं कहलाता।
Q3. Recovery के दौरान क्या precautions लेने चाहिए?
Rest, medications, और cardiac rehabilitation protocol follow करना आवश्यक है।
Q4. Prognosis कैसा है?
Good prognosis if underlying ischemia treated और supportive care दी जाए।
निष्कर्ष (Conclusion)
Myocardial Stunning (मायोकार्डियल स्टनिंग) एक reversible myocardial dysfunction है, जो ischemia और reperfusion के बाद होती है।
Early recognition, supportive cardiac care, medications और underlying coronary disease management से heart function पूरी तरह recover हो सकती है।
अगर किसी को post-MI या acute ischemic episode के बाद fatigue, dyspnea, या low cardiac output symptoms दिखें, तो cardiologist से तुरंत consultation जरूरी है।