Elikowski Waldemar, Małek Małgorzata, Pyda Małgorzata, Dziarmaga Mieczysław, Angerer Dariusz, Montewska Dominika
Józef Struś Hospital, Poznan, Poland, Department of Internal Medicine.
Pol Merkur Lekarski. 2012 Oct;33(196):202-6.
The authors present a case of a 70-year-old woman in whom clinical picture of an acute coronary syndrome with ST segment elevation was suggestive of takotsubo cardiomyopathy (TC). Chest pain, extensive ECG changes and typical TC left ventricular contraction pattern were preceded by emotional and physical stress, while in coronary angiography no atherosclerotic lesions were found. There was however left anterior descending coronary artery myocardial bridging with total systolic compression. Following treatment with beta-blocker and diltiazem, spectacular left ventricle function improvement, with near total recovery after 6 months was observed. Magnetic resonance imaging detected the presence of subendocardial late gadolinium enhancement indicative of postmyocardial scar.
作者报告了一例70岁女性病例,其急性冠状动脉综合征伴ST段抬高的临床表现提示为应激性心肌病(TC)。胸痛、广泛的心电图改变和典型的TC左心室收缩模式之前有情绪和身体应激,而冠状动脉造影未发现动脉粥样硬化病变。然而,存在左前降支冠状动脉心肌桥伴完全收缩期压迫。在用β受体阻滞剂和地尔硫䓬治疗后,观察到左心室功能显著改善,6个月后几乎完全恢复。磁共振成像检测到心内膜下晚期钆增强的存在,提示心肌梗死后瘢痕形成。