Department of Cardiology, The Queen Elizabeth Hospital, Woodville West SA 5011, Australia.
Am J Emerg Med. 2013 May;31(5):890.e1-2. doi: 10.1016/j.ajem.2012.12.037. Epub 2013 Feb 8.
Takotsubo cardiomyopathy (TTC) is uncommon emergency condition usually precipitated by emotional or physical stress and is characterized by near-normal coronary arteries and regional wall motion abnormalities that extend beyond a single coronary vascular territory. Variants of TTC include classic apical ballooning syndrome and less commonly, mid, basal, and biventricular variants. Cardiac arrest is an uncommon complication of TTC. In the convalescence phase of TTC, prolonged QTc interval may cause cardiac arrest, but the reason for cardiac arrest in the acute phase when QTc interval is normal is unclear. We report 3 cases of mid ventricular TTC, with out-of-hospital cardiac arrest as the presenting feature. All 3 patients had normal QTc interval and were found to have normal coronary arteries on cardiac catheterization at presentation. Mid ventricular TTC was confirmed on contrast left ventriculography and echocardiography. Cardiac arrest myocarditis was ruled out by myocardial biopsy in 2 deceased patients and by cardiac magnetic resonance imaging in the one who survived.
心尖球囊样综合征（TTC）是一种不常见的紧急病症，通常由情绪或身体应激引起，其特征为冠状动脉接近正常，且区域性壁运动异常超出单一冠状动脉血供区域。TTC 的变异型包括经典的心尖球囊样综合征，以及不太常见的中、基底和双心室变异型。心搏骤停是 TTC 的一种不常见并发症。在 TTC 的康复阶段，长 QT 间期可能导致心搏骤停，但在 QTc 间期正常的急性期发生心搏骤停的原因尚不清楚。我们报告了 3 例中室壁 TTC 的病例，以院外心搏骤停为主要表现。所有 3 例患者的 QTc 间期正常，在就诊时的心脏导管检查中发现冠状动脉正常。对比左心室造影和超声心动图证实了中室壁 TTC。通过心肌活检排除了 2 例死亡患者的心肌炎性心搏骤停，并通过心脏磁共振成像排除了 1 例存活患者的心肌炎性心搏骤停。
