Morrow Andrew J, Nordin Sabrina, O'Boyle Patrick, Berry Colin
Cardiology, Golden Jubilee National Hospital, Clydebank, UK.
British Heart Foundation Glasgow Cardiovascular Research Centre, University of Glasgow, Glasgow, UK.
BMJ Case Rep. 2019 Aug 28;12(8):e229618. doi: 10.1136/bcr-2019-229618.
Takotsubo cardiomyopathy (TC), otherwise known as stress cardiomyopathy, is characterised by acute, transient left ventricular systolic dysfunction with apical ballooning in the absence of obstructive epicardial coronary stenosis. The presentation of TC mimics that of acute myocardial infarction. More recently there has been a shift towards thinking of TC as a 'microvascular acute coronary syndrome'. Our case is of an 82-year-old woman who presented with TC mimicking acute anterior ST elevation myocardial infarction in the context of sepsis. Slow flow noted in the left anterior descending artery prompted us to perform coronary physiology. Her fractional flow reserve was 0.91, with an index of myocardial resistance of 117 and a coronary flow reserve of 1.6. In combination these results are indicative of microvascular coronary dysfunction in the absence of significant epicardial stenosis.
应激性心肌病（TC），又称应激性心肌病，其特征是在无阻塞性心外膜冠状动脉狭窄的情况下，出现急性、短暂的左心室收缩功能障碍伴心尖部气球样变。应激性心肌病的表现类似于急性心肌梗死。最近，人们的观念已逐渐转向将应激性心肌病视为一种“微血管急性冠状动脉综合征”。我们的病例是一位82岁女性，在脓毒症背景下出现类似急性前壁ST段抬高型心肌梗死的应激性心肌病。左前降支出现慢血流促使我们进行冠状动脉生理学检查。她的血流储备分数为0.91，心肌阻力指数为117，冠状动脉血流储备为1.6。综合这些结果表明在无明显心外膜狭窄的情况下存在微血管冠状动脉功能障碍。
