Bhogal Sukhdeep, Ladia Vatsal, Sitwala Puja, Bajaj Kailash, Ramu Vijay, Paul Timir
East Tennessee State University, Johnson City, TN, USA.
J Investig Med High Impact Case Rep. 2017 Jun 12;5(2):2324709617713512. doi: 10.1177/2324709617713512. eCollection 2017 Apr-Jun.
Broken heart syndrome or Takotsubo cardiomyopathy (TC) is a disorder characterized by transient left ventricular apical ballooning that almost invariably precedes emotional or physical stress. Although the patients with chronic kidney disease on hemodialysis have shown to exhibit sustained activity of sympathetic nervous system, the presentation of TC in these patients is a rare entity with few case reports in the literature. A 75-year-old female with past medical history of end-stage renal disease presented with chest pressure and heaviness that started during her maintenance hemodialysis session. Electrocardiogram showed ST elevation and T wave inversion in V3-V6 leads. Emergent left heart catheterization was done that showed normal coronaries and akinesis of apical left ventricle wall consistent with TC. She was started on maximal medical management and underwent hemodialysis the next day without recurrence of the symptoms. TC may an underdiagnosed entity in patients on hemodialysis. However, it should be considered in the differential diagnosis in hemodialysis patients, particularly who presents with chest pain and/or symptoms.
心碎综合征或应激性心肌病（TC）是一种以短暂性左心室心尖部气球样变为特征的疾病，几乎总是在情绪或身体应激之前出现。尽管接受血液透析的慢性肾脏病患者已显示出交感神经系统持续活跃，但这些患者中TC的表现是一种罕见情况，文献中仅有少数病例报告。一名75岁女性，有终末期肾病病史，在维持性血液透析期间开始出现胸部压迫感和沉重感。心电图显示V3-V6导联ST段抬高和T波倒置。紧急进行了左心导管检查，结果显示冠状动脉正常，左心室心尖部室壁运动消失，符合TC表现。她开始接受最大程度的药物治疗，并于次日进行了血液透析，症状未再复发。在接受血液透析的患者中，TC可能是一种未被充分诊断的疾病。然而，在血液透析患者的鉴别诊断中应考虑到该病，尤其是那些出现胸痛和/或症状的患者。
