Gonzalez Juan J, Wahab Ahsan, Elgamal Mohamed, Kesari Kavitha
Internal Medicine Department, McLaren-Flint/Michigan State University, Flint, MI, USA.
J Community Hosp Intern Med Perspect. 2018 Oct 15;8(5):279-282. doi: 10.1080/20009666.2018.1524700. eCollection 2018.
Takotsubo cardiomyopathy (TTC) is a syndrome characterized by transient regional systolic dysfunction of the left ventricle in the absence of angiographic evidence of obstructive coronary artery disease (CAD). A variety of stress-related triggers, including malignancies, have been reported in patients with TTC. However, to our knowledge, a recent diagnosis of a colon mass preceding the development of TTC has not been reported. We report on a female patient who was recently diagnosed with a colon mass by colonoscopy who was then scheduled to undergo robotic hemicolectomy, but was subsequently admitted to our hospital for intractable nausea and abdominal pain. While admitted, she developed transient ventricular tachycardia with elevated cardiac markers. The echocardiogram revealed markedly decreased ejection fraction and mid to distal apical akinesis with regional wall motion abnormalities. Coronary angiogram demonstrated no significant CAD, consistent with the diagnosis of TTC. The recently diagnosed colon mass was the most likely stress trigger in the development of TTC.
应激性心肌病（TTC）是一种以左心室短暂性局部收缩功能障碍为特征的综合征，且无阻塞性冠状动脉疾病（CAD）的血管造影证据。TTC患者中已报告了包括恶性肿瘤在内的多种与应激相关的诱因。然而，据我们所知，此前尚未有在TTC发生之前近期诊断出结肠肿物的报道。我们报告了一名女性患者，她最近通过结肠镜检查被诊断出患有结肠肿物，随后计划接受机器人辅助半结肠切除术，但随后因顽固性恶心和腹痛入住我院。住院期间，她出现了伴有心肌标志物升高的短暂性室性心动过速。超声心动图显示射血分数明显降低，心尖中部至远端运动减弱，并伴有局部室壁运动异常。冠状动脉造影显示无明显CAD，符合TTC的诊断。最近诊断出的结肠肿物很可能是该患者发生TTC的应激诱因。
