Mele Marco, Pepe Martino, Maggi Alessandro, Troccoli Rossella, Rutigliano David, Villella Alessandro
Cardiology Department, Masselli Mascia Hospital, San Severo (FG), ASL FG, Italy.
Institute of Cardiology, University of Bari, Bari, Italy.
J Cardiol Cases. 2019 Apr 20;20(2):61-64. doi: 10.1016/j.jccase.2019.04.001. eCollection 2019 Aug.
Reverse takotsubo cardiomyopathy (rTTC) is a less frequent variant of takotsubo cardiomyopathy (TTC) with several differences about epidemiology and clinical aspects. While left ventricular outflow tract (LVOT) obstruction is relatively frequent in TTC patients, this complication has not been reported in the setting of rTTC yet. We describe the case of a female patient with rTTC complicated by LVOT obstruction and systolic anterior motion of mitral valve: the onset of these findings coincided with the regression of wall motion abnormalities. This dangerous "relay race" seems to be not casual but related to the characteristics of rTTC and should be always expected and prevented. < Left ventricle outflow tract obstruction with systolic anterior motion of mitral valve is an insidious complication that may be associated with reverse takotsubo cardiomyopathy and not only with the classic takotsubo cardiomyopathy. This complication appears to be delayed and should be always expected. Close echocardiographic monitoring, careful fluid support and early start of beta-blocker therapy may prevent it.>.
反向性应激性心肌病（rTTC）是应激性心肌病（TTC）中较罕见的一种类型，在流行病学和临床方面存在一些差异。虽然左心室流出道（LVOT）梗阻在TTC患者中相对常见，但在rTTC患者中尚未有该并发症的报道。我们描述了一例患有rTTC并伴有LVOT梗阻和二尖瓣收缩期前向运动的女性患者：这些表现的出现与室壁运动异常的消退同时发生。这种危险的“接力赛”似乎并非偶然，而是与rTTC的特征有关，应始终予以警惕并预防。<二尖瓣收缩期前向运动伴左心室流出道梗阻是一种隐匿性并发症，可能与反向性应激性心肌病有关，而不仅与经典的应激性心肌病有关。这种并发症似乎出现较晚，应始终予以警惕。严密的超声心动图监测、谨慎的液体支持以及早期开始使用β受体阻滞剂治疗可能预防该并发症。>
