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[应激性心肌病。短暂性左心室运动障碍]

[Takotsubo syndrome. Transient left ventricular dyskinesia].

作者信息

Pérez Pérez F M, Sánchez Salado J

机构信息

Servicio de Emergencias, Empresa Pública de Emergencias Sanitarias de Andalucía, Servicio Provincial de Cádiz, Cádiz, España.

Servicio de Enfermería, Empresa Pública de Emergencias Sanitarias de Andalucía, Servicio Provincial de Cádiz, Cádiz, España.

出版信息

Semergen. 2014 Mar;40(2):73-9. doi: 10.1016/j.semerg.2013.01.014. Epub 2013 Apr 11.

DOI:10.1016/j.semerg.2013.01.014
PMID:23583183
Abstract

The Takotsubo syndrome, also called transient apical dyskinesia syndrome, was first described in Japan in the 1990s. It is a rare entity found in almost 1% of all patients with suspicion of acute coronary syndrome. It usually affects postmenopausal women with a few cardiovascular risk factors. It is characterized by angina-type chest pain, electrocardiographic changes, elevation of the enzymes of myocardial injury, absence of coronary obstruction on angiography, and a characteristic left ventricular anteroapical dyskinesia, which returns to normal within a few days. Severe emotional stress is the most common trigger for this syndrome. The aetiopathogenesis of this syndrome remains to be defined. This syndrome has been considered a clinical condition since 2001, when a series of 88 cases was published. It is a disease with a partially known mechanism, characterised by the morphology adopted by the left ventricle secondary to hypokinesis or dyskinesia of the apical segments, and hypercontractility of basal segments. Unlike acute coronary syndrome, patients with left ventricle dysfunction do not have atherothrombotic disease in the coronary arteries. In addition, the alterations described are reversible. Some clinical diagnostic criteria have been proposed, although they are still controversial, as well as in the complementary examinations required for diagnosis.

摘要

应激性心肌病,也称为短暂性心尖运动障碍综合征,于20世纪90年代在日本首次被描述。它是一种罕见的疾病,在所有疑似急性冠状动脉综合征的患者中约占1%。它通常影响有一些心血管危险因素的绝经后女性。其特征为心绞痛样胸痛、心电图改变、心肌损伤酶升高、血管造影显示冠状动脉无阻塞以及特征性的左心室心尖前壁运动障碍,这种障碍在数天内可恢复正常。严重的情绪应激是该综合征最常见的触发因素。该综合征的病因发病机制仍有待明确。自2001年发表一系列88例病例以来,此综合征被视为一种临床病症。它是一种机制部分已知的疾病,其特征是由于心尖段运动减弱或运动障碍以及基底段过度收缩,左心室呈现出特定的形态。与急性冠状动脉综合征不同,左心室功能障碍患者的冠状动脉不存在动脉粥样硬化血栓形成疾病。此外,所描述的改变是可逆的。尽管仍存在争议,但已经提出了一些临床诊断标准,以及诊断所需的辅助检查。

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