Khallafi Hicham, Chacko Vinod, Varveralis Nickolas, Elmi Farhad
Department of Cardiology, Easton Hospital, Easton, PA, 18042, USA.
J Invasive Cardiol. 2008 Jan;20(1):E9-13.
Takotsubo cardiomyopathy, also called transient left ventricular apical ballooning or "broken heart syndrome", is a cardiac condition that mimics the clinical presentation of acute coronary syndrome but without any evidence of obstructive atherosclerotic coronary artery disease. An episode of intense emotional or physiologic stress, serving as the nidus for a catecholamine surge, has been reported prior to presentation and is presumed to be the triggering factor playing the pathogenic role. We report a unique case of Takotsubo cardiomyopathy without any known precipitating factors. After reviewing multiple case reports and review articles, the evidence supporting a "catecholamine surge" is empirically plausible; however, our case calls this theory into question. The "aborted MI" hypothesis is more convincing as an all-inclusive nidus for the pathogenesis and clinical presentation described in Takotsubo syndrome. More detailed studies and research are needed to ascertain the pathogenesis and optimal management of this syndrome.
应激性心肌病，也称为短暂性左心室心尖气球样变或“心碎综合征”，是一种临床表现类似于急性冠状动脉综合征，但无任何阻塞性动脉粥样硬化性冠状动脉疾病证据的心脏疾病。据报道，在发病前曾有强烈的情绪或生理应激事件，作为儿茶酚胺激增的病灶，被认为是起致病作用的触发因素。我们报告一例无任何已知诱发因素的应激性心肌病罕见病例。在查阅多篇病例报告和综述文章后，支持“儿茶酚胺激增”的证据在经验上似乎合理；然而，我们的病例对此理论提出了质疑。“急性心肌梗死顿挫型”假说作为应激性心肌病所描述的发病机制和临床表现的一个全面病灶更具说服力。需要更详细的研究来确定该综合征的发病机制和最佳治疗方法。
