Bijulal Sasidharan, Harikrishnan Sivadasanpillai, Namboodiri Narayanan, Ajitkumar Valaparambil K, Gupta Deepak, Mathuranath P S
Sree Chitra Tirunal Institute for Medical Sciences and Technology, Cardiology, Trivandrum, 691303, India.
BMJ Case Rep. 2009;2009. doi: 10.1136/bcr.06.2008.0182. Epub 2009 Feb 16.
Tako-tsubo cardiomyopathy (TTC) is increasingly being recognised as transient left ventricular dysfunction following various hyperadrenergic states such as emotional or physical stressors. The association of this rare clinical entity with myasthenia gravis (MG) has been reported only twice in the literature, both following plasmapheresis for MG crisis. Here we describe a unique case of TTC in a 40-year-old woman with MG admitted with MG crisis managed conservatively. This case suggests that plasmapheresis is unlikely to have a causative role in the development of TTC in these patients. Patients with MG crisis may be at potential risk of developing TTC and careful clinical and electrocardiographic monitoring is necessary while treating them. The possible role of stress as the common precipitating factor in both conditions is also discussed.
应激性心肌病（TTC）越来越多地被认为是在各种高肾上腺素能状态（如情绪或身体应激源）后出现的短暂性左心室功能障碍。这种罕见的临床实体与重症肌无力（MG）的关联在文献中仅报道过两次，均发生在MG危象的血浆置换之后。在此，我们描述了一例40岁患有MG的女性患者，因MG危象入院并接受保守治疗，却出现了TTC这一独特病例。该病例表明，血浆置换不太可能在这些患者TTC的发生中起致病作用。MG危象患者可能有发生TTC的潜在风险，在治疗他们时，需要进行仔细的临床和心电图监测。同时也讨论了应激作为这两种情况共同促发因素的可能作用。
