Swenson Sara, Bull Justin, Chen Iris B, Joseph Dency, Joseph Jolly, Varghese Molly, Dellostritto Rita A
The University of Texas M.D. Anderson Cancer Center, Houston, Texas.
College of Nursing, Houston Center, Texas Woman's University, Denton, Texas.
J Am Assoc Nurse Pract. 2018 Jul;30(7):392-397. doi: 10.1097/JXX.0000000000000078.
Takotsubo cardiomyopathy (TCM), first reported by Japanese doctors, has gained an overall acknowledgment as an independent malady of international attention. It resembles the presentation of an acute myocardial infarction but lacks ischemic myocardial tissue. The objective of this article is to review the physiology, diagnostics, treatment, and complications of TCM and report a case study of a patient who developed TCM.
Observation through direct patient care allowed for data collection of this unique medical phenomenon. Supporting information was obtained via investigation of scholarly articles on TCM over the past 10 years.
Although TCM is usually transient, it is important to quickly differentiate TCM from other more serious medical conditions, such as myocardial infarction, pulmonary embolism, and pheochromocytoma. Typical diagnostic workup includes electrocardiography, cardiac biomarkers, and echocardiography or coronary angiography. Complications include cardiogenic shock, left ventricular wall rupture, and life-threatening arrhythmias.
The advanced practice nurse (APN) is instrumental in differentiating between TCM versus acute myocardial infarction, heart failure, pulmonary edema, dynamic outflow obstruction, and cardiogenic shock. Because of these possible acute and critical presentations, prompt recognition and intervention for patients with TCM are priorities for nurse practitioners.
日本医生首次报道的应激性心肌病（TCM）已作为一种引起国际关注的独立疾病获得了广泛认可。它类似急性心肌梗死的表现，但缺乏缺血性心肌组织。本文的目的是综述应激性心肌病的生理学、诊断、治疗及并发症，并报告一例发生应激性心肌病的患者的病例研究。
通过直接的患者护理观察来收集这一独特医学现象的数据。通过调查过去10年关于应激性心肌病的学术文章获取支持性信息。
尽管应激性心肌病通常是短暂的，但迅速将其与其他更严重的病症，如心肌梗死、肺栓塞和嗜铬细胞瘤区分开来很重要。典型的诊断检查包括心电图、心脏生物标志物以及超声心动图或冠状动脉造影。并发症包括心源性休克、左心室壁破裂和危及生命的心律失常。
高级执业护士（APN）有助于区分应激性心肌病与急性心肌梗死、心力衰竭、肺水肿、动态流出道梗阻和心源性休克。由于这些可能的急性和危急表现，对应激性心肌病患者的及时识别和干预是执业护士的首要任务。
