Department of Nuclear Medicine, ProCardiaco Hospital, Rio de Janeiro, Brazil.
Department of Radiology and Nuclear Medicine, Academic Medical Center, Amsterdam, The Netherlands.
J Nucl Cardiol. 2019 Apr;26(2):674-676. doi: 10.1007/s12350-018-1286-8. Epub 2018 May 29.
Although Takotsubo cardiomyopathy (TCM) knowledge is increasing, the exact pathophysiology remains unclear. TCM represents 1%-2% of all troponin positive acute coronary syndromes, affects predominantly postmenopausal women, and is commonly preceded by exposure to severe physical or emotional stress. Transient wall motion abnormalities mimicking ST-elevation myocardial infarction is expected as well as increase of troponin levels and echocardiography alterations. This case report is about a patient that as far as we know is the first case that shows the use of myocardial perfusion imaging in the acute phase of TCM. In general, the TCM Mayo Clinic diagnostic criteria have been very helpful in the clinical setting. In this specific case, however, the presence of reduced myocardial perfusion in the acute phase combined with increased troponin levels seemed to be in contradiction with the exclusion of obstructive coronary artery disease.
尽管 Takotsubo 心肌病（TCM）的知识在不断增加，但确切的病理生理学仍不清楚。TCM 占所有肌钙蛋白阳性急性冠状动脉综合征的 1%-2%，主要影响绝经后妇女，并且通常在经历严重的身体或情绪压力后发生。预计会出现类似于 ST 段抬高型心肌梗死的短暂壁运动异常以及肌钙蛋白水平升高和超声心动图改变。本病例报告是关于一名患者的，据我们所知，这是首例在 TCM 急性期使用心肌灌注成像的病例。一般来说，TCM 梅奥诊所诊断标准在临床环境中非常有帮助。然而，在这个特定的病例中，急性期心肌灌注减少加上肌钙蛋白水平升高似乎与排除阻塞性冠状动脉疾病相矛盾。
