Mano Yoshinori, Baba Akiyasu, Sukegawa Hiroaki, Sawano Mitsuaki, Nishiyama Takafumi, Ohki Takahiro
Department of Cardiology, Tokyo Dental College, Ichikawa General Hospital, Japan.
Intern Med. 2021 Jul 1;60(13):2097-2102. doi: 10.2169/internalmedicine.5831-20. Epub 2021 Feb 8.
We herein report a 75-year-old woman who was diagnosed with Takotsubo syndrome (TTS) complicated by left ventricular outflow tract obstruction on admission. Treatment with beta-blocker and anticoagulant was started; however, her hemoglobin level decreased gradually, and computed tomography performed one week later revealed hemopericardium. Oozing-type cardiac rupture was suspected; therefore, we discontinued heparin treatment. Finally, she recovered uneventfully without cardiac surgery. It is noteworthy that cardiac rupture may occur with TTS, especially in patients treated with prophylactic anticoagulation therapy for apical thrombus. Furthermore, conservative, careful observation is an alternative approach in patients with oozing-type cardiac rupture associated with TTS.
我们在此报告一名75岁女性,入院时被诊断为应激性心肌病(TTS)并伴有左心室流出道梗阻。开始使用β受体阻滞剂和抗凝剂进行治疗;然而,她的血红蛋白水平逐渐下降,一周后进行的计算机断层扫描显示心包积血。怀疑是渗出型心脏破裂;因此,我们停止了肝素治疗。最后,她未经心脏手术顺利康复。值得注意的是,TTS可能会发生心脏破裂,尤其是在接受预防性抗凝治疗以预防心尖血栓形成的患者中。此外,对于与TTS相关的渗出型心脏破裂患者,保守、仔细的观察是另一种治疗方法。