Slivnjak Valentina, Lakusic Nenad, Richter Davor, Cerovec Dusko
Department of Cardiology, Hospital for Medical Rehabilitation Krapinske Toplice, Croatia.
Int J Cardiol. 2009 Aug 21;136(3):e63-5. doi: 10.1016/j.ijcard.2008.05.013. Epub 2008 Aug 15.
Stress cardiomyopathy or Tako-Tsubo Syndrome (TTS) clinically manifests with sudden chest pain and/or dyspnea, and is generally triggered by emotional or physical stress. Electrocardiographic (ECG) changes are similar to acute myocardial infarction with ST-elevation, but coronarography shows no significant pathomorphological changes of coronary arteries. Ventriculography and echocardiography show reversible akinesis and ballooning of the left ventricle apex with reduced ejection fraction. Like as it is with TTS, similar ECG changes are extensively reported in patients with intracerebral bleeding. We reported the case of a 52-year-old female patient who was clinically presented with stress cardiomyopathy with ST-segment elevation of the anterolateral location complicated by a secondary massive intracranial bleeding. Many cases of TTS or ECG changes in intracranial bleeding were described separately, but to our knowledge, this is the first report where both events developed in the same patient with the fatal outcome.
应激性心肌病或Takotsubo综合征(TTS)临床上表现为突发胸痛和/或呼吸困难,通常由情绪或身体应激引发。心电图(ECG)变化类似于ST段抬高型急性心肌梗死,但冠状动脉造影显示冠状动脉无明显病理形态学改变。心室造影和超声心动图显示左心室心尖部可逆性运动减弱和球囊样扩张,射血分数降低。与TTS一样,脑出血患者也广泛报道有类似的心电图变化。我们报告了一例52岁女性患者,临床上表现为前外侧部位ST段抬高的应激性心肌病,并并发继发性大量颅内出血。许多TTS病例或颅内出血时的心电图变化是分别描述的,但据我们所知,这是第一例在同一患者中同时发生这两种情况并导致致命结果的报告。