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年轻女性慢性咳嗽的一个意外病因:心动过速性心肌病。

An unexpected cause of chronic cough in a young woman: Tachycardia-induced cardiomyopathy.

机构信息

Emergency and Critical Care Center, Kurashiki Central Hospital, Japan.

Emergency and Critical Care Center, Kurashiki Central Hospital, Japan.

出版信息

Am J Emerg Med. 2019 Mar;37(3):563.e5-563.e7. doi: 10.1016/j.ajem.2018.12.014. Epub 2018 Dec 10.

Abstract

Heart failure typically manifests with exertional dyspnea or limb edema. Old age, underlying heart disease, and coronary risk factors are known risk factors for heart failure. Thus, congestive heart failure is rarely considered as a differential diagnosis of chronic cough in a previously healthy young person. However, tachycardia-induced cardiomyopathy (TIC) can result in such a situation. A case of a previously healthy 27-year-old woman with TIC is described herein. On the first examination, the patient presented with left ventricular (LV) dysfunction caused by persistent tachyarrhythmia. Cardiomyopathy subsided with only heart rate control; therefore, the patient was diagnosed as having TIC. TIC can develop irrespective of age and underlying heart disease. The long-term outcome may be good, and LV systolic function recovers in most patients following resolution of arrhythmia. Physicians need to consider TIC as a differential diagnosis in patients of any age who present with heart failure, because prompt treatment generally leads to resolution of symptoms and ventricular function.

摘要

心力衰竭通常表现为运动性呼吸困难或肢体水肿。年龄较大、潜在心脏病和冠状动脉危险因素是心力衰竭的已知危险因素。因此,在以前健康的年轻患者中,充血性心力衰竭很少被认为是慢性咳嗽的鉴别诊断。然而,心动过速性心肌病(TIC)可能导致这种情况。本文描述了一例以前健康的 27 岁女性 TIC 病例。在第一次检查时,患者因持续性心动过速性心律失常而出现左心室(LV)功能障碍。通过仅控制心率,心肌病消退;因此,患者被诊断为 TIC。TIC 可发生于任何年龄和潜在心脏病患者。长期预后可能良好,大多数患者在心律失常得到解决后 LV 收缩功能恢复。医生需要考虑 TIC 作为任何年龄出现心力衰竭患者的鉴别诊断,因为及时治疗通常可缓解症状和改善心室功能。

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