Montassier E, Segard J, Martinage A, Goffinet N, Piriou N, Le Conte P, Potel G, Gueffet J-P
Service des urgences, hôpital Hôtel-Dieu, centre hospitalier universitaire, 1, place A.-Ricordeau, 44000 Nantes, France.
Ann Cardiol Angeiol (Paris). 2013 Aug;62(4):269-72. doi: 10.1016/j.ancard.2011.12.001. Epub 2011 Dec 27.
Tako-Tsubo cardiomyopathy, first described in 1990 by Sato in Japan, has recently gained increasing consideration when reported in non-Japanese patients, including the United States and Europe. Typical presentation mimics acute coronary syndrome, with acute chest pain and/or dyspnoea, associated to electrocardiographic changes and moderate cardiac biomarkers release, but in which coronary angiography reveals no coronary arteries lesions and echocardiography or left ventriculography shows a reversible left ventricle systolic dysfunction. Prognosis is good, in contrast to acute coronary syndrome, provided that the patients survive the possible life-threatening acute presentation, with correction of the left ventricle systolic dysfunction within several days or weeks. As noted in several reviews, 3.5% to 10% of the patients have a recurrence during the first few years after the initial presentation. Here, we described a case of a 60-year-old female who had three episodes of Tako-Tsubo always preceded by severe emotional stress suggesting a potential common etiopathogenesis.
应激性心肌病于1990年由日本的佐藤首次描述,近年来,在包括美国和欧洲在内的非日本患者中报告时受到越来越多的关注。典型表现类似急性冠状动脉综合征,伴有急性胸痛和/或呼吸困难,伴有心电图改变和中度心脏生物标志物释放,但冠状动脉造影显示无冠状动脉病变,超声心动图或左心室造影显示左心室收缩功能可逆性障碍。与急性冠状动脉综合征相反,预后良好,前提是患者能从可能危及生命的急性发作中存活下来,且左心室收缩功能在数天或数周内得到纠正。正如几篇综述中所指出的,3.5%至10%的患者在首次发作后的头几年内会复发。在此,我们描述了一例60岁女性,她有三次应激性心肌病发作,每次发作前都有严重的情绪应激,提示可能存在共同的发病机制。