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心尖球形综合征:死于心碎?

Tako-Tsubo syndrome: dying of a broken heart?

机构信息

Department of Internal Medicine II, University Medical Center, Johannes Gutenberg University Mainz, Langenbeckstrasse 1, 55131 Mainz, Germany.

出版信息

Clin Res Cardiol. 2010 Dec;99(12):771-80. doi: 10.1007/s00392-010-0224-9. Epub 2010 Sep 17.

Abstract

AIM

The aim of the article is to review the etiology, pathology and epidemiology of a disease entity named Tako-Tsubo syndrome, receiving this name according to the picture obtained during ventriculography resembling a Japanese octopus trap. The Tako-Tsubo syndrome is a diagnosis encountered in patients with acute coronary syndrome and, therefore, is important to consider.

METHODS

The literature search was performed in the MEDLINE database to identify the relevant topics. The references reported were used to complete the literature search.

RESULTS

The Tako-Tsubo syndrome is rising in incidence and makes up a relevant part of patients with acute coronary syndrome. The prevalence is described to be 0.6-2.5%. Especially, older women in the postmenopause with emotional stress are affected. The clinical changes and ECG alterations resemble the same characteristics like in acute coronary syndrome; however, the coronary arteries often show no impaired blood flow or only marginal changes. The reason for this syndrome is allocated to stress reactions with increased levels of stress hormones. As well, some patients develop contraction abnormalities like in Tako-Tsubo syndrome during intracranial bleeding, pheochromocytoma, seizures, infectious causes and sepsis, showing that not only emotional stress is responsible for the manifestation of this disease.

CONCLUSION

The prevalence of Tako-Tsubo syndrome is about 2%, therefore this syndrome has to be considered in patients with acute coronary syndrome. Despite the life-threatening complications during the acute phase, a complete regression of the contraction abnormality is often reported.

摘要

目的

本文旨在回顾一种名为 Takotsubo 综合征的疾病实体的病因、病理和流行病学,该名称取自心导管造影时类似于日本章鱼陷阱的图像。Takotsubo 综合征是急性冠状动脉综合征患者中遇到的一种诊断,因此需要考虑。

方法

在 MEDLINE 数据库中进行文献检索,以确定相关主题。使用报告的参考文献完成文献检索。

结果

Takotsubo 综合征的发病率正在上升,占急性冠状动脉综合征患者的重要部分。其患病率描述为 0.6-2.5%。特别是绝经后情绪压力大的老年女性受影响。临床变化和心电图改变与急性冠状动脉综合征的特征相似;然而,冠状动脉通常没有血流受损或只有轻微变化。这种综合征的原因归因于应激反应,应激激素水平升高。同样,一些患者在颅内出血、嗜铬细胞瘤、癫痫、感染性原因和败血症期间出现类似于 Takotsubo 综合征的收缩异常,表明不仅仅是情绪压力导致这种疾病的表现。

结论

Takotsubo 综合征的患病率约为 2%,因此在急性冠状动脉综合征患者中需要考虑这种综合征。尽管在急性发作期间存在危及生命的并发症,但经常报告收缩异常完全消退。

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