Vaz Juan, Berggren Rikard, Eriksson Berne
Department of Medicine, Halmstad Hospital, Halmstad, Sweden.
Department of Cardiology, Halmstad Hospital, Halmstad, Sweden.
Case Rep Cardiol. 2019 Jan 9;2019:6706935. doi: 10.1155/2019/6706935. eCollection 2019.
Cardiovascular disease is common among patients with chronic obstructive pulmonary disease (COPD). Takotsubo syndrome (TTS) is a transient cardiac disorder that, in its typical form, involves left ventricular dysfunction with apical ballooning and mimics acute coronary syndrome (ACS). "Bronchogenic TTS" has been proposed as a specific form of TTS (during severe acute dyspnea in asthma or COPD) with atypical presentation. Recurrent TTS in COPD seems to be exceptionally rare since only a handful of clinical cases have previously been reported in the literature. Here, we present a unique case of a frequently recurrent TTS during COPD exacerbation in a 70-year-old woman, with at least 4 different episodes of TTS within 5 years. This case report exemplifies the difficulties of the diagnosis of TTS at the onset of acute COPD exacerbation. Potential pathophysiological mechanisms and therapeutic strategies are also briefly discussed.
心血管疾病在慢性阻塞性肺疾病（COPD）患者中很常见。应激性心肌病（TTS）是一种短暂性心脏疾病，其典型形式表现为左心室功能障碍伴心尖部气球样变，酷似急性冠状动脉综合征（ACS）。“支气管源性TTS”被认为是TTS的一种特殊形式（在哮喘或COPD严重急性呼吸困难期间），具有非典型表现。COPD患者反复发生TTS似乎极为罕见，因为此前文献中仅报道过少数临床病例。在此，我们报告一例独特病例，一名70岁女性在COPD加重期间频繁反复发生TTS，5年内至少出现4次不同发作。本病例报告例证了急性COPD加重发作时TTS诊断的困难。同时也简要讨论了潜在的病理生理机制和治疗策略。
