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动态左心室流出道梗阻合并应激性心肌病:应激性心肌病急性期表现为潜在的左心室流出道梗阻。

Dynamic left ventricular outflow tract obstruction complicated with takotsubo cardiomyopathy: The acute phase of takotsubo cardiomyopathy manifests latent left ventricular outflow tract obstruction.

作者信息

Sakaguchi Yuta, Ozaki Kazuyuki, Takano Toshiki, Namba Hitomi, Tanaka Komei, Yanagawa Takao, Ozawa Takuya, Minamino Tohru

机构信息

Department of Cardiovascular Biology and Medicine, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan.

出版信息

J Cardiol Cases. 2018 May 29;18(2):60-64. doi: 10.1016/j.jccase.2018.04.010. eCollection 2018 Aug.

Abstract

Dynamic left ventricular (LV) outflow tract (LVOT) obstruction is sometimes complicated with takotsubo cardiomyopathy (TC). The present case involves a 70-year-old woman with chest discomfort. Seven years earlier, transthoracic echocardiography revealed LVOT obstruction due to a sigmoid-shaped septum. She underwent urgent cardiac catheterization for suspected acute coronary syndrome. She was diagnosed as having TC with LVOT obstruction. After undergoing conservative treatment, her LV function normalized and the LVOT obstruction resolved. After the LV wall motion normalized, administering an intravenous infusion of dobutamine again provoked LVOT obstruction. In this situation, the presence of TC manifested latent LVOT obstruction. < Although dynamic left ventricular outflow tract (LVOT) obstruction is the important compication of takotsubo cardiomyopaty (TC), the mechanism of LVOT obstruction remains unclear. This case had latent LVOT obstruction due to sigmoid-shaped septum, and LVOT obstruction might be manifested in the acute phase of TC. This phenomenon has potential for mechanism of LVOT obstruction complicated with TC.>.

摘要

动态左心室流出道(LVOT)梗阻有时会并发应激性心肌病(TC)。本病例为一名70岁有胸部不适的女性。7年前,经胸超声心动图显示由于S形间隔导致LVOT梗阻。她因疑似急性冠状动脉综合征接受了紧急心脏导管插入术。她被诊断为患有伴有LVOT梗阻的TC。经过保守治疗后,她的左心室功能恢复正常,LVOT梗阻也得到缓解。左心室壁运动恢复正常后,再次静脉输注多巴酚丁胺诱发了LVOT梗阻。在这种情况下,TC的存在表现出潜在的LVOT梗阻。<虽然动态左心室流出道(LVOT)梗阻是应激性心肌病(TC)的重要并发症,但LVOT梗阻的机制仍不清楚。本病例因S形间隔存在潜在的LVOT梗阻,且LVOT梗阻可能在TC的急性期表现出来。这种现象对于并发TC的LVOT梗阻机制具有潜在意义。>

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本文引用的文献

1
Manifestation of Latent Left Ventricular Outflow Tract Obstruction in the Acute Phase of Takotsubo Cardiomyopathy.
Intern Med. 2016;55(23):3413-3420. doi: 10.2169/internalmedicine.55.7119. Epub 2016 Dec 1.
2
Clinical impact of left ventricular outflow tract obstruction in takotsubo cardiomyopathy.
Circ J. 2015;79(4):839-46. doi: 10.1253/circj.CJ-14-1148. Epub 2015 Jan 28.
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