Geng Shuren, Mullany Dan, Fraser John F
Second Hospital of Xi'an Jiaotong University, Xi'an, China.
Crit Care Resusc. 2008 Sep;10(3):231-4.
A 65-year-old woman was transferred from another hospital with a diagnosis of acute myocardial infarction associated with shock. An initial electrocardiogram (ECG) showed ST-segment elevation in leads V1-V6. A transoesophageal echocardiogram showed akinesis of the distal anterior septum and apical regions and hyperkinesis of the basal segments, with an ejection fraction of 20%- 25%. The coronary angiogram showed trivial coronary disease. By Day 6 of admission, the ECG showed normal left ventricle size and systolic function, with an ejection fraction of 65% and no regional abnormalities of wall motion. Sputum examination subsequently revealed typical Streptococcus pneumoniae. Our case demonstrates for the first time an association between sepsis and takotsubo cardiomyopathy. We analyse the possible role of sepsis and the systemic inflammatory response syndrome caused by severe infection as the initial causative mechanism of this syndrome.
一名65岁女性从另一家医院转来，诊断为急性心肌梗死合并休克。初始心电图（ECG）显示V1-V6导联ST段抬高。经食管超声心动图显示前间隔远端和心尖区域运动减弱，基底节段运动增强，射血分数为20%-25%。冠状动脉造影显示冠状动脉病变轻微。入院第6天，心电图显示左心室大小和收缩功能正常，射血分数为65%，无室壁运动区域异常。痰检随后发现典型的肺炎链球菌。我们的病例首次证明了脓毒症与应激性心肌病之间的关联。我们分析了脓毒症和严重感染引起的全身炎症反应综合征作为该综合征初始致病机制的可能作用。
