由边缘性脑炎引起的心尖部气球样变。
Apical ballooning resulting from limbic encephalitis.
作者信息
Gelow Jill, Kruer Michael, Yadav Vijayshree, Kaul Sanjiv
机构信息
Division of Cardiovascular Medicine, Oregon Health and Science University, Portland, OR 97239-3098, USA.
出版信息
Am J Med. 2009 Jun;122(6):583-6. doi: 10.1016/j.amjmed.2008.12.016.
BACKGROUND
Neurogenic stunned myocardium is an increasingly recognized cause of left ventricular apical ballooning, or takotsubo cardiomyopathy. We report the first case of neurogenic stunned myocardium as a result of limbic encephalitis.
METHODS
This 73-year-old woman with anterograde and retrograde amnesia was investigated using electrocardiography, magnetic resonance imaging, and left ventricular angiography.
RESULTS
Electrocardiography showed deep T-wave inversions in multiple leads, magnetic resonance imaging demonstrated increased signal on fluid-attenuated inversion recovery images symmetrically within the medial temporal lobes consistent with limbic encephalitis. Left ventricular angiography showed apical ballooning.
CONCLUSIONS
Because the insula has extensive interconnections with limbic structures, limbic encephalitis could lead to alterations in the sympathetic regulation of the insular cortex resulting in neurogenic stunned myocardium.
背景
神经源性心肌顿抑是左心室心尖部气球样变（即应激性心肌病）越来越被认可的病因。我们报告首例因边缘叶脑炎导致神经源性心肌顿抑的病例。
方法
对这位患有顺行性和逆行性失忆的73岁女性进行了心电图、磁共振成像及左心室血管造影检查。
结果
心电图显示多个导联出现深T波倒置，磁共振成像显示内侧颞叶内液体衰减反转恢复图像上信号对称增强，符合边缘叶脑炎表现。左心室血管造影显示心尖部气球样变。
结论
由于脑岛与边缘结构有广泛的相互联系，边缘叶脑炎可能导致脑岛皮质交感神经调节改变，从而引起神经源性心肌顿抑。
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