Win Cho M, Pathak Amit, Guglin Maya
University of South Florida and Tampa General Hospital, Tampa, FL 33606, USA.
Congest Heart Fail. 2011 Jan-Feb;17(1):38-41. doi: 10.1111/j.1751-7133.2010.00195.x. Epub 2011 Jan 12.
The diagnosis of stress-induced cardiomyopathy requires wall motion abnormality, most typically apical ballooning. The authors report 3 cases of transient global left ventricular systolic dysfunction that developed over the course of severe medical illnesses. The cardiomyopathy that developed in each patient had all the features of takotsubo cardiomyopathy, including reversibility, mild troponin elevation, nonspecific electrocardiographic abnormalities, and a negative work-up for ischemia. The only difference was the absence of regional wall motion abnormalities. No patients developed sepsis or myocarditis. Stress-induced cardiomyopathy may present in different forms, including regional or global left ventricular dysfunction. Classic takotsubo syndrome may represent only part of the spectrum of this reversible condition.
应激性心肌病的诊断需要存在室壁运动异常，最典型的表现为心尖部气球样变。作者报告了3例在严重内科疾病过程中发生的短暂性全心左心室收缩功能障碍病例。每位患者所发生的心肌病具有应激性心肌病的所有特征，包括可逆性、肌钙蛋白轻度升高、非特异性心电图异常以及缺血相关检查结果阴性。唯一的不同之处在于不存在局部室壁运动异常。没有患者发生脓毒症或心肌炎。应激性心肌病可能以不同形式出现，包括局部或全心左心室功能障碍。典型的应激性心肌病综合征可能仅代表这种可逆性病症范围的一部分。
