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应激性心肌病:压力如何模拟急性冠状动脉闭塞。

Tako-tsubo cardiomyopathy: how stress can mimic acute coronary occlusion.

作者信息

Abdulla Irfan, Ward Michael R

机构信息

Faculty of Medicine, University of Sydney, Sydney, NSW, Australia.

出版信息

Med J Aust. 2007 Sep 17;187(6):357-60. doi: 10.5694/j.1326-5377.2007.tb01281.x.

Abstract

Tako-tsubo cardiomyopathy (TTC) is an important differential diagnosis of acute coronary occlusive myocardial infarction that should be understood by all clinicians. Although TTC is frequently clinically indistinguishable from acute left anterior descending coronary artery occlusion, it is readily differentiated with coronary angiography. The increasing frequency of acute angiography and revascularisation for patients with acute myocardial infarction has resulted in TTC being far more frequently diagnosed. Most common in postmenopausal women, TTC is frequently precipitated by physical or emotional stress, and after an acute phase during which the patient may be significantly haemodynamically compromised, there is rapid recovery and an excellent prognosis. After diagnosis the patient can be reassured and advised of the low rates of recurrence. Currently, no specific preventive therapy has been proven to be effective.

摘要

应激性心肌病(TTC)是急性冠状动脉闭塞性心肌梗死的重要鉴别诊断,所有临床医生都应了解。尽管TTC在临床上常与急性左前降支冠状动脉闭塞难以区分,但通过冠状动脉造影很容易鉴别。急性心肌梗死患者进行急性血管造影和血运重建的频率增加,导致TTC的诊断更为频繁。TTC在绝经后女性中最为常见,常由身体或情绪应激诱发,在急性期患者可能出现明显的血流动力学损害,之后会迅速恢复且预后良好。诊断后可让患者放心,并告知其复发率较低。目前,尚未证明任何特定的预防治疗有效。

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