Inoue Teruhiro, Yanagawa Youichi, Omori Kazuhiko, Osaka Hiromichi, Oode Yasumasa, Sugita Manabu, Okamoto Ken
Department of Acute Critical Care Medicine Shizuoka Hospital Juntendo University Izunokuni Shizuoka Japan.
Department of Emergency and Intensive Care Juntendo Nerima Hospital Juntendo University Nerima Tokyo Japan.
Acute Med Surg. 2014 Apr 30;1(3):176-180. doi: 10.1002/ams2.34. eCollection 2014 Jul.
A 76-year-old woman was found unconscious by her family. She had suffered a fall and was soaked in kerosene. On arrival at our emergency department, she was unconscious, normotensive, with right hemiplegia and chemical burns. A computed tomographic scan of her head indicated left thalamic hemorrhage. An electrocardiogram showed ST elevation at the precardial leads. An echocardiogram revealed characteristic of takotsubo cardiomyopathy.
The patient was intubated and treated conservatively. She was transferred to another hospital for rehabilitation after complete epithelization of the chemical burn. This is the second reported case of thalamic hemorrhage with takotsubo cardiomyopathy. The thalamic hemorrhage might have induced autonomic disturbances and caused the takotsubo cardiomyopathy in this case.
Physicians should pay attention to the potential complication of takotsubo cardiomyopathy, which may affect cardiopulmonary function even when patients are being treated for intracerebral hemorrhage.
一名76岁女性被家人发现昏迷。她曾摔倒并被煤油浸湿。到达我们的急诊科时，她昏迷不醒，血压正常，伴有右侧偏瘫和化学烧伤。头部计算机断层扫描显示左侧丘脑出血。心电图显示胸前导联ST段抬高。超声心动图显示有应激性心肌病的特征。
患者插管并接受保守治疗。化学烧伤完全上皮化后，她被转至另一家医院进行康复治疗。这是第二例报道的伴有应激性心肌病的丘脑出血病例。在本病例中，丘脑出血可能引发自主神经紊乱并导致了应激性心肌病。
医生应注意应激性心肌病的潜在并发症，即使在患者接受脑出血治疗时，该并发症也可能影响心肺功能。
