Takotsubo cardiomyopathy precipitated by negative pressure pulmonary oedema following total thyroidectomy.
Takotsubo cardiomyopathy precipitated by negative pressure pulmonary oedema following total thyroidectomy.
复制标题
DOI：
10.4103/0019-5049.177872
复制
发表时间：
2016-03
影响因子：
2.9
通讯作者：
Gurudatt CL
中科院分区：
文献类型：
--
作者：
Bharathi KS;Kulkarni S;Sadananda KS;Gurudatt CL
“Takotsubo心肌病（TCM）”或“应激性心肌病”是一种可逆的心肌病，由强烈的情绪或身体压力引起。这种综合征的特征是症状类似急性冠脉综合征，伴有与局部室壁运动异常相关的短暂收缩功能障碍，在没有阻塞性冠状动脉疾病的情况下，这种收缩功能障碍延伸到单个冠状动脉血管床之外。中医证候与心肌梗死相似，均以突发胸痛、气促、心电图及心肌酶谱异常为主要表现。在心脏导管插入确定诊断之前，很难区分两者。我们报告一例中医在绝经后女性，沉淀的负压肺水肿后，甲状腺全切除术，及时心导管建立诊断和影响的管理。提高对这种独特的心肌病的认识对于在高危人群中迅速诊断围手术期发生的应激相关心肌病综合征具有高度的怀疑指数至关重要。
‘Takotsubo cardiomyopathy (TCM)’ or ‘stress cardiomyopathy’ is a reversible cardiomyopathy that is precipitated by intense emotional or physical stress. This syndrome is characterised by symptoms mimicking acute coronary syndrome with transient systolic dysfunction associated with regional wall motion abnormalities, which extend beyond a single coronary vascular bed in the absence of obstructive coronary vascular disease. The presentation of TCM and myocardial infarction is similar with sudden onset of chest pain, breathlessness as well as abnormalities in both the electrocardiogram and cardiac enzymes. It is difficult to differentiate between the two until cardiac catheterisation establishes the diagnosis. We report a case of TCM in a post-menopausal female, precipitated by negative pressure pulmonary oedema following total thyroidectomy in whom timely cardiac catheterisation established the diagnosis and influenced the management. Heightened awareness of this unique cardiomyopathy is essential to have a high index of suspicion in at-risk population for the prompt diagnosis of stress-related cardiomyopathy syndromes occurring in the perioperative period.