Kosuge Masami, Kimura Kazuo
Division of Cardiology, Yokohama City University Medical Center, Yokohama, Japan.
Division of Cardiology, Yokohama City University Medical Center, Yokohama, Japan.
J Electrocardiol. 2014 Sep-Oct;47(5):684-9. doi: 10.1016/j.jelectrocard.2014.03.004. Epub 2014 Mar 26.
Takotsubo cardiomyopathy (TC) is a recently recognized novel cardiac syndrome characterized by transient left ventricular dysfunction without obstructive coronary disease, electrocardiographic (ECG) changes (ST-segment elevation and/or negative T wave) or elevated cardiac enzymes. Because the clinical features and ECG findings of TC mimic those of anterior acute myocardial infarction (AMI) with occlusion of the left anterior descending coronary artery, differential diagnosis has an important role in selecting the most appropriate treatment strategy. Especially in the acute phase, differential diagnosis is essential for deciding whether reperfusion therapy is required. Although it has been suggested that ECG does not allow reliable differentiation between TC and anterior AMI, several ECG criteria distinguishing TC from anterior AMI have been proposed. In this review, we discuss ECG findings of TC, especially in the acute phase, compare them with those of anterior AMI, and identify ECG features that may facilitate early recognition of this disease.
应激性心肌病（TC）是一种最近才被认识的新型心脏综合征，其特征为无阻塞性冠状动脉疾病的短暂性左心室功能障碍、心电图（ECG）改变（ST段抬高和/或T波倒置）或心肌酶升高。由于TC的临床特征和心电图表现与左前降支冠状动脉闭塞所致的前壁急性心肌梗死（AMI）相似，因此鉴别诊断在选择最合适的治疗策略中具有重要作用。特别是在急性期，鉴别诊断对于决定是否需要再灌注治疗至关重要。尽管有人认为心电图无法可靠地区分TC和前壁AMI，但已经提出了一些将TC与前壁AMI区分开来的心电图标准。在这篇综述中，我们讨论TC的心电图表现，尤其是急性期的表现，将它们与前壁AMI的表现进行比较，并确定可能有助于早期识别这种疾病的心电图特征。
