Apical ballooning syndrome (Tako-Tsubo or stress cardiomyopathy): A mimic of acute myocardial infarction
Apical ballooning syndrome (Tako-Tsubo or stress cardiomyopathy): A mimic of acute myocardial infarction
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DOI：
10.1016/j.ahj.2007.11.008
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发表时间：
2008-03-01
影响因子：
4.8
通讯作者：
Rihal, Charanjit S.
中科院分区：
文献类型：
--
作者：
Prasad, Abhiram;Lerman, Amir;Rihal, Charanjit S.
心尖气球综合征(ABS)是一种独特的可逆性心肌病，常由应激事件诱发，其临床表现与心肌梗死难以区分。我们回顾了有关ABS的病理生理学、临床特征、调查和治疗的最佳证据。据估计，在出现急性心肌梗死的患者中，ABS的发生率为1%至2%。其病理生理机制尚不清楚，但儿茶酚胺介导的心肌顿抑是最受欢迎的解释。胸痛和呼吸困难是典型的临床症状。心电图上可能出现一过性ST段抬高，而心肌肌钙蛋白T的小幅升高是恒定的。典型的表现为左心室中段和心尖段运动减退或心动过缓，基础收缩功能受损，无梗阻性冠状动脉病变。支持性治疗几乎在所有患者中都能导致自发的快速康复。预后良好，复发发生在
Apical ballooning syndrome (ABS) is a unique reversible cardiomyopathy that is frequently precipitated by a stressful event and has a clinical presentation that is indistinguishable from a myocardial infarction. We review the best evidence regarding the pathophysiology, clinical features, investigation, and management of ABS. The incidence of ABS is estimated to be 1% to 2% of patients presenting with an acute myocardial infarction. The pathophysiology remains unknown, but catecholamine mediated myocardial stunning is the most favored explanation. Chest pain and dyspnea are the typical presenting symptoms. Transient ST elevation may be present on the electrocardiogram, and a small rise in cardiac troponin T is invariable. Typically, there is hypokinesis or alkinesis of the mid and apical segments of the left ventricle with sparing of the basal systolic function without obstructive coronary lesions. Supportive treatment leads to spontaneous rapid recovery in nearly all patients. The prognosis is excellent, and a recurrence occurs in