Gervais Mai-Kim, Gagnon André, Henri Margaret, Bendavid Yves
aUniversité de Montréal bDepartment of Internal Medicine, Division of Cardiology cDepartment of General Surgery, Hôpital Maisonneuve-Rosemont, Montréal, Québec, Canada.
J Cardiovasc Med (Hagerstown). 2015 Jan;16 Suppl 2:S113-7. doi: 10.2459/JCM.0b013e3283356651.
The classical entity of Takotsubo cardiomyopathy is well established in the literature, but mechanisms explaining it remain unelucidated. Recently, the uncommon inverted Takotsubo type (sparing apical ballooning) has been more frequently described. We report the case of a 26-year-old man admitted with gastrointestinal symptoms, whose clinical presentation for a stress-related cardiomyopathy, which usually presents with cardiopulmonary symptoms, was rather atypical. The cardiac assessment including echocardiography and cardiac magnetic resonance imaging (MRI) demonstrated a dilated cardiomyopathy, whereas coronary angiography showed the absence of atherosclerotic disease. The abdominal computed tomography (CT) scan revealed a left adrenal mass, and elevated urinary catecholamine levels were highly suggestive of a pheochromocytoma. Prompt medical and surgical treatments were instituted. During the left adrenalectomy the patient suffered from brief electromechanical dissociation requiring aggressive resuscitation. Postoperative course was unremarkable. Reverse Takotsubo heart failure is a recently recognized syndrome and a systematic review of the literature of 10 cases of pheochromocytoma-induced inverted Takotsubo is presented in the present article.
应激性心肌病的经典类型在文献中已有充分记载，但其发病机制仍不明确。近来，一种罕见的倒Tako - tsubo型（无心尖部气球样变）被更多地报道。我们报告了一名26岁因胃肠道症状入院的男性病例，其因应激性心肌病的临床表现较为非典型，该病通常表现为心肺症状。包括超声心动图和心脏磁共振成像（MRI）在内的心脏评估显示为扩张型心肌病，而冠状动脉造影显示无动脉粥样硬化疾病。腹部计算机断层扫描（CT）显示左肾上腺肿块，尿儿茶酚胺水平升高高度提示嗜铬细胞瘤。随即采取了药物和手术治疗。在左肾上腺切除术期间，患者出现短暂的心电机械分离，需要积极复苏。术后病程平稳。反向Tako - tsubo心力衰竭是一种最近才被认识的综合征，本文对10例嗜铬细胞瘤诱发的倒Tako - tsubo病例进行了文献系统综述。
