Cardiology Research Department, West Wing, Royal Victoria Hospital, Grosvenor Road, Belfast BT126BA, UK.
Anesth Analg. 2010 Mar 1;110(3):708-11. doi: 10.1213/ane.0b013e3181a96fb9. Epub 2009 Jul 17.
Reversible stress-induced cardiomyopathy, i.e., Takotsubo cardiomyopathy, rarely presents in preoperative patients. We provide the case reports of two patients who presented with Takotsubo cardiomyopathy, which we surmise was due to excess endogenous catecholamine production in response to acute pain. Electrocardiogram revealed T-wave inversion, with peak Troponin-T elevation in each case, i.e., 0.66 microg/L and 0.14 microg/L (normal range <0.03 microg/L). Despite these findings consistent with acute myocardial infarction, neither patient had obstructive coronary disease at angiography. Left ventriculography showed apical ballooning, a typical feature of the Takotsubo syndrome. Ventricular dysfunction had resolved completely at repeat echocardiography 2 wk later, after adequate analgesia and surgery.
应激性心肌病，也称心尖球形综合征，在术前患者中罕见。我们提供了两例Takotsubo 心肌病患者的病例报告，我们推测这是由于急性疼痛引起的内源性儿茶酚胺过度产生所致。心电图显示 T 波倒置，每个病例的肌钙蛋白 T 峰值升高，分别为 0.66μg/L 和 0.14μg/L（正常范围<0.03μg/L）。尽管这些发现与急性心肌梗死一致，但在血管造影中，这两个患者均无阻塞性冠状动脉疾病。左心室造影显示心尖球囊样变，这是 Takotsubo 综合征的一个典型特征。在充分的镇痛和手术后 2 周的重复超声心动图检查时，心室功能障碍已完全恢复。
