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应激性心肌病患者并发长QT综合征和尖端扭转型室速:一例罕见病例。

Long-QT syndrome and torsades de pointes in a patient with Takotsubo cardiomyopathy: an unusual case.

作者信息

Mahida Saagar, Dalageorgou Chrysoula, Behr Elijah R

机构信息

Department of Cardiology, St George's Hospital, Blackshaw Road, London, UK.

出版信息

Europace. 2009 Mar;11(3):376-8. doi: 10.1093/europace/eun336. Epub 2008 Dec 18.

Abstract

Takotsubo cardiomyopathy is a syndrome characterized by transient left ventricular apical ballooning associated with electrocardiogram (ECG) changes and minimal myocardial enzymatic release, mimicking acute myocardial infarction in patients without significant coronary disease at angiography. We report an unusual case of a patient who presented with Takotsubo cardiomyopathy associated with long-QT syndrome and who developed cardiac arrest secondary to torsades de pointes.The relationship between Takotsubo cardiomyopathy and abnormal repolarization has been well documented. Despite this, there have been few reports of malignant ventricular arrhythmias or sudden death. This report suggests that prolongation of QTc interval in Takotsubo cardiomyopathy may not be as benign as previously suggested but may in fact uncover an abnormality of repolarization that may be genetic in basis and carry a risk of sudden death.

摘要

应激性心肌病是一种综合征,其特征为短暂性左心室心尖部气球样变,伴有心电图(ECG)改变及心肌酶少量释放,在血管造影时无显著冠状动脉疾病的患者中类似急性心肌梗死。我们报告了1例不寻常的患者,该患者表现为应激性心肌病合并长QT综合征,并继发尖端扭转型室速导致心脏骤停。应激性心肌病与复极异常之间的关系已有充分文献记载。尽管如此,关于恶性室性心律失常或猝死的报道却很少。本报告提示,应激性心肌病中QTc间期延长可能并非如之前所认为的那样良性,实际上可能揭示了一种复极异常,其可能具有遗传基础并伴有猝死风险。

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