Mena L M, Martín F, Melero A, Ramos A, Jiménez I R
Servicio de Medicina Nuclear, SESCAM, Hospital General Virgen de la Luz, Cuenca, Spain.
Rev Esp Med Nucl. 2011 Mar-Apr;30(2):104-6. doi: 10.1016/j.remn.2010.09.009. Epub 2011 Feb 22.
Takotsubo syndrome can mimic an acute myocardial infarction. It is characterized by anginal chest pain with ST elevation in precordial leads, no coronary obstruction on angiography, and typical and reversible deformation of the left ventricular due to antero-apical ballooning with basal hyperkinesis. The pathophysiology of this syndrome is uncertain. It is probably multifactorial, cardiac adrenergic nervous dysfunction standing out in the acute phase. We report two cases performed within the diagnostic context of Takotsubo syndrome. Cardiac SPECT was performed using (123)I Metaiodobenzylguanidine (MIBG) and (99m)Tc-Tetrofosmin and the results of two cases were adrenergic denervation in the anterior wall without alterations in myocardial perfusion study. Identification of Takotsubo syndrome is of clinical importance because its management and prognosis differ significantly from that of acute myocardial infarction.
应激性心肌病可酷似急性心肌梗死。其特征为心前区导联ST段抬高伴心绞痛样胸痛，血管造影显示无冠状动脉阻塞，以及因心尖前壁气球样变伴基底段运动增强导致左心室典型的、可逆性变形。该综合征的病理生理学尚不确定。其可能是多因素的，在急性期突出表现为心脏肾上腺素能神经功能障碍。我们报告了在应激性心肌病诊断背景下开展的两例病例。使用（123）I间碘苄胍（MIBG）和（99m）Tc-替曲膦进行了心脏单光子发射计算机断层显像（SPECT），两例病例的结果均为前壁肾上腺素能去神经支配，而心肌灌注研究无改变。应激性心肌病的识别具有临床重要性，因为其治疗和预后与急性心肌梗死显著不同。
