Wessex Cardiothoracic Unit, Southampton University Hospitals NHS Trust, Southampton, SO16 6YD, UK.
Postgrad Med J. 2011 Jan;87(1023):51-9. doi: 10.1136/pgmj.2010.102475. Epub 2010 Nov 7.
The frequency of the diagnosis of takotsubo cardiomyopathy has increased rapidly over the past few years, possibly due to increasing awareness among cardiologists. At initial presentation the diagnosis remains a challenge because of the close similarity between the presentation of takotsubo cardiomyopathy, and that of ST elevation myocardial infarction (STEMI). Recognition of salient aspects of the medical history at presentation are important in order to organise further appropriate investigations such as echocardiography and left ventriculography at the time of coronary angiogram. Takotsubo cardiomyopathy can be easily missed without ventriculography early after presentation because of the transient nature of left ventricular dysfunction, and in many centres left ventriculogram is not done as standard in the setting of STEMI. The authors advocate left ventriculography in all cases of ST elevation who have unobstructed coronaries. The correct diagnosis of takotsubo cardiomyopathy is very important for future advice and management of the patient. The prognosis of this condition is generally excellent with almost all patients returning to normal within a few weeks. This article examines the takotsubo cardiomyopathy literature and discusses the pathophysiology, clinical features, management, and prognosis of this condition in the context of an illustrated case.
近年来，由于心脏病专家的认识不断提高，心尖球囊样综合征（takotsubo 心肌病）的诊断频率迅速增加。由于心尖球囊样综合征的表现与 ST 段抬高型心肌梗死（STEMI）非常相似，因此在初始表现时，诊断仍然具有挑战性。为了在进行冠状动脉造影时及时进行进一步的适当检查，如超声心动图和左心室造影，了解发病时病史的显著方面非常重要。由于左心室功能障碍的短暂性质，takotsubo 心肌病在发病后早期很容易被漏诊，如果在 STEMI 情况下，许多中心都不将左心室造影作为标准检查。作者主张对所有冠状动脉通畅的 ST 段抬高患者进行左心室造影。正确诊断 takotsubo 心肌病对患者的未来建议和管理非常重要。这种情况的预后通常非常好，几乎所有患者在几周内都会恢复正常。本文研究了 takotsubo 心肌病的文献，并结合一个实例讨论了这种情况的病理生理学、临床特征、治疗和预后。
