Nguyen Lan T, Schelbert Erik B, Cook Stephen C
Department of Cardiovascular Medicine, University of Pittsburgh, Pittsburgh, PA, USA.
Cardiovascular Magnetic Resonance Center, Heart and Vascular Institute, University of Pittsburgh, Pittsburgh, PA, USA.
World J Pediatr Congenit Heart Surg. 2016 May;7(3):381-4. doi: 10.1177/2150135115589998. Epub 2015 Dec 23.
Takotsubo cardiomyopathy is a reversible form of cardiomyopathy rarely reported in the adult congenital patient. We describe a case of a 49-year-old woman with repaired tetralogy of Fallot who presented with acute dyspnea. A 12-lead electrocardiogram revealed diffuse anterolateral T-wave inversion suggestive of myocardial ischemia. Cardiac catheterization was performed, demonstrating angiographically normal coronary arteries. A cardiovascular magnetic resonance examination showed apical akinesis with associated myocardial edema, but no myocardial damage on late gadolinium enhancement imaging, which is a characteristic of Takotsubo cardiomyopathy. The patient was treated medically. A follow-up echocardiogram demonstrated normalization of left ventricular systolic function and apical wall motion abnormalities.
应激性心肌病是一种可逆性心肌病,在成年先天性心脏病患者中鲜有报道。我们描述了一例49岁法洛四联症修补术后女性患者,该患者出现急性呼吸困难。12导联心电图显示广泛前侧壁T波倒置,提示心肌缺血。进行了心导管检查,血管造影显示冠状动脉正常。心血管磁共振检查显示心尖运动减弱并伴有心肌水肿,但延迟钆增强成像未显示心肌损伤,这是应激性心肌病的特征。该患者接受了药物治疗。随访超声心动图显示左心室收缩功能及心尖壁运动异常恢复正常。