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[短暂性左心室心尖气球样变综合征。病例报告及文献复习]

[Transient left ventricular apical ballooning syndrome. Case report and review of the literature].

作者信息

Roux X, Chevalier J-M, Laplace G, Brandstatt P, Bire F, Massoure P-L

机构信息

Hôpital d'instruction des armées Robert-Picqué, 351, route de Toulouse, 33998 Bordeaux-Armées, France.

出版信息

Rev Med Interne. 2006 Oct;27(10):776-82. doi: 10.1016/j.revmed.2006.06.014. Epub 2006 Jul 14.

Abstract

SUBJECT

Transient left ventricular apical ballooning syndrome, known as the japanese name of tako-tsubo was recently described and is characterised at the acute period by a large apical dyskinesia of the left ventricule apex. This syndrome usually mimics an acute coronary syndrome, sometime a cardiac failure or arrhythmias. We report a typical case of a seventy-seven years old women struck by a tako-tsubo syndrome revealed by an acute chest pain after an emotional stress. The diagnosis was proposed because angiography didn't shown any abnormality in spite of a large left ventricular dysfunction at the ventriculography. Actuality and strong points: Tako-tsubo syndrome is more and more published due to a better knowledge of this syndrome, specially in the acute coronary syndrome without coronary abnormality. His physiopathology is not well known but is clearly in relation with an acute stress. Several hypothesis are discussed, helped by some experimental animal model. With an excellent prognosis at a middle-course, his discovery allow an adapted take care especially of the complications.

PROSPECT

The setting up of clinic and electrocardiographic reliable and well-tried criteria will allowed an early diagnosis to avoid harmful treatment. His specific treatment is not reached by consensus but will develop by a better knowledge of the physiopathology.

摘要

主题

短暂性左心室心尖球囊综合征,其日语名称为“ tako-tsubo”,最近被描述,急性期特征为左心室心尖部大面积运动障碍。该综合征通常模仿急性冠状动脉综合征,有时模仿心力衰竭或心律失常。我们报告了一例典型病例,一名77岁女性因情绪应激后突发胸痛而被诊断为tako-tsubo综合征。尽管心室造影显示左心室功能严重障碍,但血管造影未显示任何异常,因此提出了该诊断。现状与优势:由于对该综合征有了更好的了解,尤其是在无冠状动脉异常的急性冠状动脉综合征中,tako-tsubo综合征的报道越来越多。其病理生理学尚不清楚,但显然与急性应激有关。在一些实验动物模型的帮助下,讨论了几种假说。由于中期预后良好,其发现有助于采取适当的治疗措施,尤其是针对并发症。

展望

建立可靠且经过充分验证的临床和心电图标准将有助于早期诊断,避免有害治疗。其具体治疗方法尚未达成共识,但随着对病理生理学的深入了解将会得到发展。

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