Ali Zain, Zain Muhammad Abdullah, Khan Mariya, Ahmad Asrar, Abbas Hassan, Ashfaq Ammar Ali
Resident Physician, Internal medicine, Abington Memorial Hospital, Abington, PA, USA.
Department of Internal Medicine, Sheikh Zayed Medical College and Hospital, Rahim Yar Khan, Pakistan.
J Community Hosp Intern Med Perspect. 2019 Apr 12;9(2):171-174. doi: 10.1080/20009666.2019.1598229. eCollection 2019 Apr.
Takotasubo Cardiomyopathy (TCM), also known as broken heart syndrome, is a syndrome of transient and reversible cardiac dysfunction in the absence of obstructive coronary artery disease following an unpleasant emotional event. TCM commonly presents as chest pain mimicking acute coronary syndrome (ACS) in character. The most common electrocardiogram (EKG) findings associated with TCM are ST-segment elevation or T wave inversion. Herein, we present a case of TCM in an individual who presented with a sudden onset chest pressure following a stressful event. She was found to have QT interval prolongation on EKG and elevated troponins. Initially thought to have non-ST elevation myocardial infarction (NSTEMI). Cardiac catheterization did not reveal coronary artery disease. The ventriculography suggested apical ballooning and the diagnosis of TCM with atypical EKG presentation. Our case is unique as we describe an atypical electrocardiographic presentation of TCM. Our case emphasizes that physicians should refrain from prescribing QT-prolonging drugs to patients with TCM, to avert potential QT prolongation and progression to torsade de pointes (TDP).
应激性心肌病（TCM），也被称为心碎综合征，是一种在不愉快情绪事件后出现的、无阻塞性冠状动脉疾病情况下的短暂且可逆的心脏功能障碍综合征。TCM通常表现为类似急性冠状动脉综合征（ACS）特征的胸痛。与TCM相关的最常见心电图（EKG）表现是ST段抬高或T波倒置。在此，我们报告一例应激性心肌病病例，该患者在压力事件后突然出现胸部压迫感。她的心电图显示QT间期延长，肌钙蛋白升高。最初被认为患有非ST段抬高型心肌梗死（NSTEMI）。心脏导管检查未发现冠状动脉疾病。心室造影显示心尖部气球样改变，诊断为具有非典型心电图表现的应激性心肌病。我们的病例很独特，因为我们描述了应激性心肌病的非典型心电图表现。我们的病例强调医生不应给应激性心肌病患者开可延长QT间期的药物，以避免潜在的QT间期延长和发展为尖端扭转型室性心动过速（TDP）。
