Banavalikar Bharatraj, Sivasubramonian Sivasankaran, Namboodiri Narayanan, Nair Krishna Kumar Mohanan, Behera Dibya Ranjan, Valaparambil Ajitkumar
Department of Cardiology, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Thiruvananthapuram, Kerala, India.
Department of Cardiology, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Thiruvananthapuram, Kerala, India.
J Electrocardiol. 2017 Sep-Oct;50(5):690-693. doi: 10.1016/j.jelectrocard.2017.05.005. Epub 2017 May 18.
Takotsubo syndrome is an acute reversible heart failure syndrome triggered by physical or emotional stress, especially in postmenopausal women. Herein, we describe a case of a 31-year-old pacemaker dependent lady who presented with syncope after she was bereaved of her father. Electrocardiogram at admission revealed ventricular paced rhythm at 60/min, prolonged QT interval and frequent runs of torsades de pointes. Transthoracic echocardiogram and left ventriculogram revealed findings typical of Takotsubo syndrome. QT prolongation and torsade de pointes in the context of fixed-rate ventricular pacing imply direct catecholamine toxicity on the ventricular myocardium independent of heart rate.
应激性心肌病是一种由身体或情绪应激引发的急性可逆性心力衰竭综合征，尤其多见于绝经后女性。在此，我们描述一例31岁依赖起搏器的女性患者，她在父亲去世后出现晕厥。入院时心电图显示心室起搏心律为60次/分钟，QT间期延长，频发尖端扭转型室性心动过速。经胸超声心动图和左心室造影显示出应激性心肌病的典型表现。在固定频率心室起搏情况下出现QT延长和尖端扭转型室性心动过速意味着儿茶酚胺对心室心肌有直接毒性作用，且与心率无关。
