Division of Cardiology, Department of Internal Medicine, Long Island College Hospital, Brooklyn, New York, USA.
J Cardiovasc Med (Hagerstown). 2010 Jan;11(1):49-52. doi: 10.2459/JCM.0b013e32832d862f.
Takotsubo cardiomyopathy, or transient left ventricular apical ballooning or broken heart syndrome, is characterized by excessive sympathetic stimulation induced acute coronary vasospasm. A 46-year-old female presented with polyuria and polydypsia and was diagnosed with new-onset diabetes mellitus, treated with insulin and intravenous fluids. During the hospital stay, she complained of an episode of left-sided chest pain and had mildly elevated cardiac enzymes. EKG showed new ST-segment elevation in V2, V3 leads without reciprocal changes. Her coronary angiogram showed no significant coronary artery stenosis, but severe systolic dysfunction and akinesis of the mid-anterior, anteroapical, mid-inferior and inferoapical segments. Further workup was negative except for plasma metanephrine being elevated. MRI of the abdomen showed a right adrenal mass consistent with pheochromocytoma. Surgical resection of the adrenal mass showed evidence of pheochromocytoma and the patient's symptoms were resolved.
应激性心肌病，也称心尖球囊样综合征或心碎综合征，其特征为过度的交感神经刺激引起急性冠状动脉痉挛。一位 46 岁女性因多尿、多饮就诊，被诊断为新发糖尿病，给予胰岛素和静脉补液治疗。住院期间，她诉左侧胸痛，且心肌酶轻度升高。心电图示 V2、V3 导联新出现 ST 段抬高，无对应性改变。冠状动脉造影未见明显冠状动脉狭窄，但中段前壁、前侧壁、中段下壁和下侧壁运动明显减弱，呈收缩期室壁瘤样改变。进一步检查除血清单甲氧基肾上腺素升高外无其他异常。腹部 MRI 显示右侧肾上腺肿块，符合嗜铬细胞瘤。肾上腺肿块切除术后，嗜铬细胞瘤得到证实，患者症状缓解。
