Virk Hafeez Ul Hassan, Inayat Faisal
Department of Medicine, Mount Sinai St. Luke's and Mount Sinai Roosevelt Hospitals, Icahn School of Medicine, New York City, New York, USA.
Department of Medicine, New York-Presbyterian Hospital, Weill Cornell Medical College, New York City, New York, USA.
N Am J Med Sci. 2016 Jul;8(7):316-9. doi: 10.4103/1947-2714.187156.
Takotsubo cardiomyopathy (TCM) mimics acute coronary syndrome and is accompanied by reversible left ventricular apical ballooning in the absence of angiographically significant coronary artery stenosis. It is a transient condition that typically precedes physical or emotional triggers.
We describe the case of a 65-year-old woman who presented to our institution with symptomatic Clostridium difficile infection. 24 hours after admission, the patient complained of severe, retrosternal chest pain. Electrocardiogram showed diffuse elevation of ST-segment in the chest leads; however, coronary angiography demonstrated normal coronary arteries. Therein, an echocardiography was performed, which revealed apical ballooning and hypercontractile base with global left ventricular hypokinesis. These features were consistent with TCM. The patient was managed conservatively. Repeat echocardiogram 2 weeks later showed resolution of heart failure.
To our research, this is the first report of TCM caused by C. difficile infection. Clinicians involved in the care of patients with C. difficile infection must be aware of this complication and should consider TCM in those who develop atypical chest pain.
应激性心肌病（TCM）酷似急性冠状动脉综合征，在无血管造影显示明显冠状动脉狭窄的情况下伴有可逆性左心室心尖部气球样变。它是一种短暂性病症，通常在身体或情绪触发因素之前出现。
我们描述了一名65岁女性的病例，该患者因有症状的艰难梭菌感染前来我院就诊。入院24小时后，患者主诉严重的胸骨后胸痛。心电图显示胸导联ST段弥漫性抬高；然而，冠状动脉造影显示冠状动脉正常。在此情况下，进行了超声心动图检查，结果显示心尖部气球样变以及基底段心肌收缩增强伴左心室整体运动减弱。这些特征符合应激性心肌病。该患者接受了保守治疗。2周后复查超声心动图显示心力衰竭症状缓解。
据我们的研究，这是首例由艰难梭菌感染引起的应激性心肌病报告。参与艰难梭菌感染患者护理的临床医生必须意识到这种并发症，对于出现非典型胸痛的患者应考虑应激性心肌病。
