Sakuragi Satoru, Tokunaga Naoto, Okawa Keisuke, Kakishita Mikio, Ohe Tohru
Department of Cardiovascular Medicine, Okayama University Graduate School of Medicine and Dentistry, 2-5-1 Shikata, Okayama, 700-8558, Japan.
Heart Vessels. 2007 Jan;22(1):59-63. doi: 10.1007/s00380-006-0931-3. Epub 2007 Jan 26.
A 59-year-old woman was admitted for consciousness disturbance. She had a history of endocranial operation for astrocytoma. Her electrocardiogram showed ST-segment elevation indicative of acute myocardial infarction. Emergency coronary angiography showed normal coronary arteries, whereas left ventriculography showed extensive severe hypokinesis in the anteroseptal and apical segments. Electroencephalography showed slow sharp wave activity from the left frontal lobe to the temporal lobe, and she was diagnosed as having status epilepticus. This is a rare case of takotsubo cardiomyopathy associated with epileptic seizure. Acute myocardial ischemia caused by impaired coronary microcirculation induced by abnormal catecholamine release is a possible cause of cardiac wall motion abnormality, as in our case.
一名59岁女性因意识障碍入院。她有星形细胞瘤颅内手术史。她的心电图显示ST段抬高，提示急性心肌梗死。急诊冠状动脉造影显示冠状动脉正常，而左心室造影显示前间隔和心尖段广泛严重运动减弱。脑电图显示从左额叶到颞叶有缓慢的尖波活动，她被诊断为癫痫持续状态。这是一例与癫痫发作相关的罕见的应激性心肌病病例。如我们的病例所示，异常儿茶酚胺释放引起的冠状动脉微循环受损导致的急性心肌缺血是心脏壁运动异常的一个可能原因。
