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[产后应激性心肌病:病例报告]

[Postpartum Takotsubo cardiomyopathy: case report].

作者信息

de Sousa Vera Cristina Pereira, Pinto Ana Patrícia Lopes, Lopes Ana Paula Calado, Gomes Fernanda Maria Ervedoso, Pinho Maria de Lurdes das Neves Ferreira, Marques Maria Isabel Silva

机构信息

Serviço de Ginecologia e Obstetrícia, Centro Hospitalar Barreiro Montijo, Barreiro, Portugal.

出版信息

Rev Bras Ginecol Obstet. 2015 Nov;37(11):526-32. doi: 10.1590/SO100-720320150005391.

Abstract

Takotsubo cardiomyopathy is characterized by acute and transient dysfunction of the apical segment of the left ventricle usually after an intense physical or emotional stress, mimicking an acute coronary syndrome. Because this is a rare syndrome, the differential diagnosis is particularly important and a high level of suspicion is essential. Obstetricians should be aware to diagnose and deal with this unexpected event. Treatment is essentially supportive, with spontaneous and complete reversal of the changes within days or weeks. The occurrence of complications may dictate a less benign prognosis. We report a case of Takotsubo cardiomyopathy in a 39-year-old woman who underwent Cesarean delivery. She presented with bradycardia, chest pain and pulmonary edema immediately after the delivery. Her echocardiography showed and apical ballooning. Cardiac biomarkers and electrocardiogram were altered and echocardiogram showed severe left ventricular dysfunction with hypokinesia of the anterior wall. Coronary angiography excluded obstructive coronary artery disease.

摘要

应激性心肌病的特征是通常在强烈的身体或情绪应激后,左心室心尖段出现急性和短暂性功能障碍,酷似急性冠状动脉综合征。由于这是一种罕见综合征,鉴别诊断尤为重要,高度怀疑至关重要。产科医生应注意诊断和处理这一意外情况。治疗主要是支持性的,数天或数周内变化可自发且完全逆转。并发症的发生可能预示预后较差。我们报告一例39岁行剖宫产的女性发生应激性心肌病的病例。她产后立即出现心动过缓、胸痛和肺水肿。她的超声心动图显示心尖部膨出。心脏生物标志物和心电图有改变,超声心动图显示严重左心室功能障碍伴前壁运动减弱。冠状动脉造影排除了阻塞性冠状动脉疾病。

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