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一名患有肥厚型心肌病的患者出现应激性心肌病

Takotsubo Cardiomyopathy in a Patient with Preexisting Hypertrophic Cardiomyopathy.

作者信息

Elhosseiny Sherif, Spagnola Jonathon, Royzman Roman, Lafferty James, Bogin Marc

机构信息

Internal Medicine, Staten Island University Hospital, Staten Island, USA.

Cardiology, Staten Island University Hospital, Staten Island, USA.

出版信息

Cureus. 2018 Nov 12;10(11):e3579. doi: 10.7759/cureus.3579.

Abstract

Takotsubo cardiomyopathy (TCM) is a condition characterized by transient left ventricular dysfunction and apical ballooning, best seen on an echocardiogram or left ventriculogram. It mimics acute myocardial infarction but without evidence of coronary artery disease on an angiogram. Hypertrophic cardiomyopathy (HCM) is an autosomal dominant heart muscle disease that is significant with hypertrophy of the left ventricle with various morphologies. We hereby report a case of TCM in a male patient with a known history of HCM. The patient's hemodynamic findings were challenging because the TCM produced an increased left ventricular outflow tract (LVOT) gradient that was previously not seen on his prior echocardiogram or cardiac catheterizations. Assessment and continuous monitoring are warranted in such a rare case. Supportive care afterward with beta blockers, along with echocardiogram surveillance, are the mainstay of management of such a patient.

摘要

应激性心肌病(TCM)是一种以短暂性左心室功能障碍和心尖部气球样变为特征的疾病,在超声心动图或左心室造影上表现最为明显。它酷似急性心肌梗死,但血管造影显示无冠状动脉疾病证据。肥厚型心肌病(HCM)是一种常染色体显性遗传性心肌疾病,以左心室肥厚且形态多样为显著特征。我们在此报告一例有HCM病史的男性患者发生TCM的病例。该患者的血流动力学表现具有挑战性,因为TCM导致左心室流出道(LVOT)梯度增加,而此前其超声心动图或心导管检查均未发现此情况。对于这种罕见病例,有必要进行评估和持续监测。此后,使用β受体阻滞剂进行支持性治疗并结合超声心动图监测,是此类患者治疗的主要手段。

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