Zavar Reihaneh, Vakhshoori Mehrbod, Mirmohammadsadeghi Mohsen, Hashemi-Jazi Mohammad
Assistant Professor, Cardiac Rehabilitation Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran.
General Practitioner, Heart Failure Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran.
ARYA Atheroscler. 2019 Jan;15(1):33-37. doi: 10.22122/arya.v15i1.1885.
Takotsubo syndrome (TS) is a reversible left ventricular (LV) systolic dysfunction occurred mostly in post-menopausal women after an emotional or physical stress. The exact mechanism has yet to be found. In clinical settings, TS should be differentiated from myocardial infarction (MI) due to totally different management protocols. Several diagnostic criteria are available, but mayo clinic criteria is the most widely used. Prognosis of TS is favorable and the recurrence and mortality rates are low. Treatment is mostly supportive and after a few weeks, most of patients' electrocardiography (ECG) and echocardiographic findings will be normalized, though to its benign course, TS can cause some complications. Intra-myocardial dissection and LV apical aneurysm, as a complication of TS has never been reported yet and was just announced in rare cases of MI.
Our patient was a 32-year-old aphasic woman referring with palpitation and chest discomfort. Further examinations after exclusion of MI revealed TS leading to LV apical aneurysm and intra-myocardial dissection.
Intra-myocardial dissection should be considered as one of the rarest TS complications. Several studies are necessary for defining the exact pathophysiological mechanisms.
应激性心肌病（TS）是一种可逆的左心室（LV）收缩功能障碍，主要发生在绝经后女性经历情绪或身体应激之后。确切机制尚未明确。在临床环境中，由于治疗方案完全不同，TS应与心肌梗死（MI）相鉴别。有多种诊断标准，但梅奥诊所标准应用最为广泛。TS的预后良好，复发率和死亡率较低。治疗主要是支持性的，几周后，大多数患者的心电图（ECG）和超声心动图检查结果会恢复正常，尽管TS病程呈良性，但仍可引发一些并发症。心肌内夹层和左心室心尖部动脉瘤作为TS的并发症此前从未有过报道，仅在罕见的心肌梗死病例中被提及。
我们的患者是一名32岁失语女性，因心悸和胸部不适前来就诊。排除心肌梗死后的进一步检查显示为TS，导致左心室心尖部动脉瘤和心肌内夹层。
心肌内夹层应被视为最罕见的TS并发症之一。需要开展多项研究以明确确切的病理生理机制。
