Pruthi Sonal, Kobrossi Semaan, Bartaula Rajeev, Chaudhuri Debanik
Department of Medicine, State University of New York, Upstate Medical University, Syracuse, NY, USA.
Department of Medicine, Division of Cardiology, State University of New York, Upstate Medical University, Syracuse, NY, USA.
Am J Emerg Med. 2017 Oct;35(10):1586.e3-1586.e4. doi: 10.1016/j.ajem.2017.07.079. Epub 2017 Jul 27.
Midventricular Takotsubo cardiomyopathy (TC) is a relatively rare variant of stress induced cardiomyopathy, wherein there is akinesis of only the mid-ventricular segment with or without hyperkinesis of apical and basal ventricular segments. The ECG findings of TC typically do not include ST segment elevation in V1-V2 and are unlikely to be associated with reciprocal changes in inferior leads. The presence of these changes argues strongly in favor of anterior wall STEMI. In our patient, the ECG had changes strongly suggestive of STEMI, however had normal coronaries on cardiac catheterization. This case highlights the importance of carefully analyzing the ECG in emergency situations for differences between TC and STEMI and when in doubt, cardiac catheterization should be pursued.
心室中部应激性心肌病（TC）是应激性心肌病中一种相对罕见的类型，其中心室中部节段仅出现运动不能，伴或不伴有心尖部和心室基底节段运动增强。TC的心电图表现通常不包括V1-V2导联ST段抬高，且不太可能与下壁导联的对应性改变相关。这些改变的存在强烈提示前壁ST段抬高型心肌梗死（STEMI）。在我们的患者中，心电图有强烈提示STEMI的改变，但心脏导管检查显示冠状动脉正常。该病例强调了在紧急情况下仔细分析心电图以鉴别TC和STEMI的重要性，如有疑问，应进行心脏导管检查。
