Takotsubo Cardiomyopathy
Takotsubo Cardiomyopathy
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DOI：
10.1007/s11606-013-2756-y
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发表时间：
2013
影响因子：
5.7
通讯作者：
Fares Alahdab;Suresh Sharma;J. Freeman
中科院分区：
文献类型：
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作者：
Fares Alahdab;Suresh Sharma;J. Freeman
一名老年男性因与邻居发生争执而出现严重情绪困扰，出现持续 1 周的呼吸困难。心电图未显示急性冠状动脉综合征（ACS）的迹象。肌钙蛋白 I 轻度升高（1.34 ng/ml；正常值 0–0.05）。超声心动图显示左心室收缩功能严重降低，心尖部和中远端前壁段运动减退。左心室造影显示心尖部、中远端前外侧和下壁节段运动严重减退，但基底节段动力亢进（图 1）（在线视频），类似于日本章鱼陷阱（图 2）。冠状动脉造影显示非阻塞性冠状动脉疾病。 Takotsubo 心肌病 (CMP) 的诊断是根据心室造影和临床情况做出的。压力诱发的 CMP（或 Takotsubo CMP）是一种越来越多记录的综合征，最常见于女性。 1 它由左心室心尖部和心室中部的短暂收缩功能障碍组成，通常伴有左心室基底部的代偿性运动亢进。 2 通常由急性身体或情绪压力引发，3 通常表现为胸痛；尽管患者也可能会抱怨呼吸困难和出汗。 4 由于 Takotsubo CMP 的临床表现与 ACS 相似，因此在鉴别诊断胸痛时应考虑 Takotsubo CMP。致谢：
A n elderly male presented with dyspnea for 1 week that began after severe emotional distress over a dispute with neighbors. Electrocardiogram did not reveal signs of acute coronary syndrome (ACS). Troponin I was mildly elevated (1.34 ng/ml; normal 0–0.05). Echocardiography demonstrated severely reduced left ventricular systolic function with hypokinetic apex and mid to distal anterior wall segments. Left ventriculography revealed a severely hypokinetic apex and mid to distal anterolateral and inferior wall segments, but hyperdynamic basal segments,(Fig. 1),(Online Video), resembling a Japanese octopus trap (Fig. 2). Coronary angiography showed nonobstructive coronary artery disease. A diagnosis of Takotsubo cardiomyopathy (CMP) was made based on the ventriculogram and the clinical context. Stress-induced CMP, or Takotsubo CMP, is an increasingly documented syndrome that is most commonly found in women. 1 It consists of transient systolic dysfunction of the left ventricular apex and mid-ventricle, often with compensatory hyperkinesis of the left ventricular base. 2 It is frequently triggered by acute physical or emotional stress, 3 and usually presents with chest pain; though patients might also complain of dyspnea and diaphoresis. 4 With a clinical presentation similar to that of an ACS, Takotsubo CMP should be considered in the differential diagnoses of chest pain.Acknowledgments: