de Sousa Marta, Casado André, Marques Alexandre Buinhas, Machado Francisco Pereira, Esperança Isabel
Internal Medicine Department, Centro Hospitalar do Médio Tejo, E.P.E., Torres Novas, Portugal.
Intensive Care Unit, Hospital da Luz, Lisbon, Portugal.
Eur J Case Rep Intern Med. 2018 Apr 24;5(4):000831. doi: 10.12890/2018_000831. eCollection 2018.
Takotsubo syndrome (TS) is an acute and reversible clinical syndrome characterized by transient hypokinesis of the left ventricular (LV) apex. Variant forms of LV dysfunction have been reported, including inverted Takotsubo syndrome (ITS), which represents only 5% of cases and has previously been linked to excessive use of inhaled adrenergic beta-2 agonists. The authors describe the case of a 60-year-old female patient who was diagnosed with ITS after the excessive use of inhaled adrenergic beta-2 agonists. This case highlights an uncommon variant of this syndrome that may not be obvious and must be suspected in this particular context.
Takotsubo syndrome (TS) was initially described with a classic pattern of LV apical akinesis and accounts for around 75-80% of cases. Variants including inverted Takotsubo (also known as basal variant) can affect other areas of the myocardium.Several physiopathological mechanisms have been implicated. Catecholamine-induced cardiotoxicity is one of the most supported theories, while other triggers, including excessive use of inhaled beta-2 agonists, have also been described.Treatment of TS is mainly symptomatic and conservative and frequently leads to rapid resolution and LV function recovery.
应激性心肌病（TS）是一种急性且可逆的临床综合征，其特征为左心室（LV）心尖部短暂运动减弱。已报道了左心室功能障碍的变异形式，包括倒置型应激性心肌病（ITS），其仅占病例的5%，且此前已与吸入性肾上腺素能β2激动剂的过度使用有关。作者描述了一名60岁女性患者的病例，该患者在过度使用吸入性肾上腺素能β2激动剂后被诊断为ITS。该病例突出了这种综合征的一种罕见变异形式，其可能并不明显，在这种特定情况下必须予以怀疑。
应激性心肌病（TS）最初被描述为具有左心室心尖部运动不能的经典模式，约占病例的75 - 80%。包括倒置型应激性心肌病（也称为基底型变异）在内的变异型可影响心肌的其他区域。
已涉及多种生理病理机制。儿茶酚胺诱导的心脏毒性是最受支持的理论之一，而其他触发因素，包括吸入性β2激动剂的过度使用，也已被描述。
TS的治疗主要是对症和保守治疗，通常会迅速缓解并使左心室功能恢复。
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