Chen Wei-Siang, Hung Ming-Jui
Section of Cardiology, Department of Internal Medicine and Community Medicine Research Center, Chang Gung Memorial Hospital-Keelung, Chang Gung University College of Medicine, Taoyuan, Taiwan.
Medicine (Baltimore). 2019 Apr;98(16):e15190. doi: 10.1097/MD.0000000000015190.
Takotsubo syndrome (TTS) is a form of acute and usually reversible heart failure syndrome. Transient left ventricular dysfunction and electrocardiographic changes could mimic acute coronary syndrome but there are actually no obstructive coronary lesions.
A 76-year-old woman with chronic lung disease developed spontaneous tension pneumothorax with the presentation of severe dyspnea, respiratory failure, left ventricular dysfunction, and anterior wall ST-segment elevation on 12-lead electrocardiogram. Acute coronary syndrome was excluded by normal coronary angiograms.
The patient was diagnosed as tension pneumothorax complicated by TTS.
The woman underwent tubal thoracostomy for tension pneumothorax-induced obstructive shock. However, the patient further underwent ligation bullectomy for persistent air leakage 2 weeks later.
The left ventricular dysfunction recovered 1 week after resolution of tension pneumothorax. Anterior wall ST-segment elevation resolved 25 days after admission.
Concurrent electrocardiograms and echocardiographic serial evaluations should be performed to provide more comprehensive information when dealing with tension pneumothorax patients.
应激性心肌病（TTS）是一种急性且通常可逆的心力衰竭综合征。短暂的左心室功能障碍和心电图改变可能类似急性冠脉综合征，但实际上并无阻塞性冠状动脉病变。
一名患有慢性肺病的76岁女性出现自发性张力性气胸，表现为严重呼吸困难、呼吸衰竭、左心室功能障碍以及12导联心电图显示前壁ST段抬高。冠状动脉造影正常排除了急性冠脉综合征。
该患者被诊断为张力性气胸并发TTS。
该女性因张力性气胸导致的梗阻性休克接受了胸腔闭式引流术。然而，2周后患者因持续漏气进一步接受了肺大疱结扎切除术。
张力性气胸缓解1周后左心室功能障碍恢复。入院25天后前壁ST段抬高消失。
在处理张力性气胸患者时，应同时进行心电图和超声心动图系列评估，以提供更全面的信息。
