Dersch Wolfgang, Rolfes Caroline, Wulf Hinnerk
Intensivtherapie, Universitätsklinikum Gießen und Marburg, Standort Marburg.
Anasthesiol Intensivmed Notfallmed Schmerzther. 2012 Jan;47(1):22-4. doi: 10.1055/s-0032-1301376. Epub 2012 Jan 27.
A 69-year-old woman reported that underwent endonasal frontal sinus surgery under general anesthesia. In her medical history the patient reports a multiple occurrence of angina pectoris attacks, especially in stressful situations. Coronary heart disease has so far been excluded. At preoperative presentation of this patient was in good general and nutritional state. Intraoperative hypotension had to be treated with norepinephrine. In the recovery room, the patient developed angina pectoris symptoms and the ECG showed T negativity. The patient was admitted on an ICU. Coronary angiography showed left ventricular apical ballooning with a transient akinesia typical of the left ventricle, as is seen in a Tako-Tsubo syndrome. The symptoms are similar to acute coronary artery disease, but without stenosis of coronary arteries. Physical or emotional stress is known to trigger Tako-Tsubo Syndrome, but the exact etiology or pathophysiology remains somewhat unclear.
一名69岁女性报告称在全身麻醉下接受了鼻内镜下额窦手术。在她的病史中,患者报告多次发生心绞痛发作,尤其是在压力大的情况下。迄今为止已排除冠心病。该患者术前一般状况和营养状况良好。术中低血压必须用去甲肾上腺素治疗。在恢复室,患者出现心绞痛症状,心电图显示T波倒置。患者被收入重症监护病房。冠状动脉造影显示左心室心尖部气球样扩张,伴有典型的左心室短暂运动不能,这在应激性心肌病中可见。症状与急性冠状动脉疾病相似,但冠状动脉无狭窄。已知身体或情绪应激会引发应激性心肌病,但其确切病因或病理生理学仍尚不完全清楚。