Papanikolaou John, Makris Demosthenes, Tsolaki Vasiliki, Spathoulas Konstantinos, Zakynthinos Epaminondas
Department of Critical Care, University Hospital of Larissa, School of Medicine, University of Thessaly, Larissa, Thessaly, Greece.
Am J Emerg Med. 2017 Jun;35(6):935.e1-935.e3. doi: 10.1016/j.ajem.2016.12.034. Epub 2016 Dec 19.
Takotsubo Cardiomyopathy (TTC) is a type of transient, yet severe left ventricular systolic dysfunction, rarely complicating extreme emotional stress ("primary" TTC) or critical medical/surgical illness ("secondary" TTC forms). Although usually reversible, TTC may result in cardiogenic shock with dismal prognosis. "Secondary" TTC forms are particularly in danger for this complication, bearing significantly worse short and long-term prognosis. Herein, we report a rare case of a life-threatening "secondary" TTC in a patient with post-cesarean section severe hemorrhage, and we point out that early co-administration of esmolol and levosimendan might be an effective and safe therapeutic approach in "reversing" TTC-induced cardiogenic shock, especially when invasive therapeutic strategies are practically unfeasible.
应激性心肌病（TTC）是一种短暂但严重的左心室收缩功能障碍，极少并发于极端情绪应激（“原发性”TTC）或严重内科/外科疾病（“继发性”TTC类型）。尽管通常可逆转，但TTC可能导致心源性休克，预后不佳。“继发性”TTC类型尤其容易出现这种并发症，其短期和长期预后明显更差。在此，我们报告一例剖宫产术后严重出血患者发生危及生命的“继发性”TTC罕见病例，并指出早期联合使用艾司洛尔和左西孟旦可能是“逆转”TTC所致心源性休克的一种有效且安全的治疗方法，特别是在侵入性治疗策略实际不可行时。
