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[应激性心肌病;由压力诱发的可逆性心肌病]

[Takotsubo cardiomyopathy; reversible cardiomyopathy induced by stress].

作者信息

Jongman Jesse K, van Tol Cora A E, Nienhuis Mark B, Debrauwere Jan, San Walther Jap Tjoen, Elvan Arif

机构信息

Isala klinieken, afd. Cardiologie, Zwolle, The Netherlands.

出版信息

Ned Tijdschr Geneeskd. 2009;153:B363.

Abstract

Takotsubo cardiomyopathy was diagnosed in a 79-year-old woman. She visited her husband who had been admitted for primary percutaneous coronary intervention, and during her visit she developed acute chest pain. Further investigation revealed transient left ventricular apical ballooning, diagnosed as takotsubo cardiomyopathy. This clinical syndrome is characterized by transient regional left ventricle wall motion abnormalities without significant epicardial coronary stenosis. It is provoked by stressful events. Especially in elderly women presenting with the clinical features of an ST-elevation myocardial infarction, takotsubo cardiomyopathy should be considered as an alternative diagnosis. Regarding the exact aetiology and pathophysiology many questions remain unanswered. With supportive treatment the prognosis is favourable.

摘要

一名79岁女性被诊断为应激性心肌病。她去探望因接受急诊经皮冠状动脉介入治疗而住院的丈夫,在探望期间突发急性胸痛。进一步检查发现短暂性左心室心尖部气球样变,诊断为应激性心肌病。这种临床综合征的特点是短暂性局部左心室壁运动异常,而无明显的心外膜冠状动脉狭窄。它由应激事件诱发。特别是对于表现出ST段抬高型心肌梗死临床特征的老年女性,应考虑应激性心肌病作为一种替代诊断。关于确切病因和病理生理学,许多问题仍未得到解答。通过支持性治疗,预后良好。

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