Gordon Ayla, LaCapra Gina, Roberti Roberto
Overlook Medical Center, Summit, NJ, USA.
Case Rep Crit Care. 2017;2017:4287125. doi: 10.1155/2017/4287125. Epub 2017 Apr 3.
The first published case of Diabetic Ketoacidosis-induced Takotsubo cardiomyopathy was in 2009. Our patient is the 1st reported case of Diabetic Ketoacidosis- (DKA-) induced Takotsubo cardiomyopathy (TC) in a patient with known hypertrophic cardiomyopathy (HOCM) in the United States. In the literature, there are only two examples linking DKA to TC; however, this report focuses on the biochemical and physiological causes of TC in a patient with known HOCM and new-onset DKA. TC in previously diagnosed HOCM poses particular complications. With the above patient's baseline outflow tract obstruction due to septal hypertrophy, the acute reduction in EF due to TC resulted in transient drop in brain perfusion and, therefore, syncope.
糖尿病酮症酸中毒诱发的应激性心肌病的首例报道病例于2009年出现。我们的患者是美国首例有报道的已知肥厚型心肌病（HOCM）患者发生糖尿病酮症酸中毒（DKA）诱发的应激性心肌病（TC）。在文献中，仅有两例将DKA与TC联系起来的病例；然而，本报告重点关注已知HOCM和新发DKA患者发生TC的生化和生理原因。先前诊断为HOCM的患者发生TC会带来特殊并发症。由于上述患者因室间隔肥厚存在基线流出道梗阻，TC导致的射血分数急性降低造成脑灌注短暂下降，进而导致晕厥。
