Arora Sandeep, Alfayoumi Fadi, Srinivasan Venkatraman
Department of Internal Medicine, Western Pennsylvania Hospital/Temple University Program, 4800 Friendship Ave, Pittsburgh, PA 15224, USA.
Mayo Clin Proc. 2006 Jun;81(6):829-32. doi: 10.4065/81.6.829.
We describe a patient who developed acute chest pain after using cocaine and had ST-segment elevation in the anterior leads on electrocardiography with mild elevation of cardiac enzymes. Cardiac catheterization showed normal coronary arteries with no coronary vasospasm. Left ventricular angiography revealed typical ballooning of the left ventricular apex during systole with an estimated left ventricular ejection fraction of 25%. The symptoms improved during the next few hours, and follow-up echocardiography 4 days later showed complete resolution of the left ventricular dysfunction. Transient left ventricular apical ballooning (LVAB) was diagnosed. To our knowledge, LVAB (also known as Takotsubo cardiomyopathy or "broken heart syndrome") has not been reported previously in association with cocaine use. We discuss the possible pathophysiologic link between LVAB and cocaine-induced cardiotoxicity.
我们描述了一名患者，其在使用可卡因后出现急性胸痛，心电图前壁导联ST段抬高，心肌酶轻度升高。心脏导管检查显示冠状动脉正常，无冠状动脉痉挛。左心室血管造影显示收缩期左心室尖部典型的气球样改变，估计左心室射血分数为25%。症状在接下来的几个小时内有所改善，4天后的随访超声心动图显示左心室功能障碍完全消退。诊断为短暂性左心室尖部气球样变（LVAB）。据我们所知，LVAB（也称为应激性心肌病或“心碎综合征”）此前尚未见与使用可卡因相关的报道。我们讨论了LVAB与可卡因诱导的心脏毒性之间可能的病理生理联系。
