Acute Medicine, Western Infirmary, UK.
Scott Med J. 2013 Feb;58(1):e15-9. doi: 10.1177/0036933012474605.
Takotsubo cardiomyopathy (TCM), first described in Japan in the early 1990s, is a reversible non-ischaemic cardiomyopathy of unclear aetiology characterised by transient left ventricular dysfunction. It mimics acute myocardial infarction with ST segment changes (STEMI), although evidence of occlusive coronary artery disease is absent. TCM is typically triggered by an intense physical or emotional stress event. We report a case of TCM diagnosed in a recently widowed lady in whom a myocardial infarction was initially suspected. This case illustrates the importance of an awareness of this unique clinical entity. Without appreciation of differentiating features, TCM can easily be misdiagnosed as an acute coronary syndrome. Misdiagnosis and the subsequent inappropriate and potentially harmful use of fibrinolytic therapy can be avoided through careful history-taking, clinical examination and appropriate investigations. Although well reported in the medical literature, this case of TCM provides the basis of a timely summary and update on current understanding of this perplexing condition.
心尖球形综合征（Takotsubo 心肌病），又称应激性心肌病，于上世纪 90 年代初在日本首次被描述，是一种病因不明的、以短暂左心室功能障碍为特征的可逆性非缺血性心肌病。其临床表现类似于急性 ST 段抬高型心肌梗死（STEMI），但不存在阻塞性冠状动脉疾病的证据。Takotsubo 心肌病通常由强烈的身体或情绪应激事件引发。我们报告了一例在最近丧偶的女士中诊断的心尖球形综合征，最初怀疑为心肌梗死。该病例说明了认识这种独特临床实体的重要性。如果不了解其鉴别特征，Takotsubo 心肌病很容易被误诊为急性冠状动脉综合征。通过仔细询问病史、临床检查和适当的检查，可以避免误诊和随后不适当且潜在有害的纤溶治疗。尽管在医学文献中有很好的报道，但这个 Takotsubo 心肌病的病例为目前对这种令人困惑的疾病的理解提供了及时的总结和更新。
