J Emerg Nurs. 2021 Jul;47(4):635-642. doi: 10.1016/j.jen.2020.12.014. Epub 2021 Mar 12.
Licensed independent practitioners in emergency clinical practice are tasked with differentiating acute cardiac presentations. Despite its similarity in clinical presentation to acute coronary syndrome, Takotsubo cardiomyopathy is a unique cardiac disorder characterized by a stress-induced ballooning of the myocardium. Also known as the broken heart syndrome, Takotsubo cardiomyopathy most frequently occurs after an overwhelming emotional or physical stressor. The subsequent impaired contractility of the heart places the patient at risk of complications, including acute heart failure, cardiogenic shock, thromboembolism, arrhythmias, and left ventricular outflow obstruction. Takotsubo cardiomyopathy is similar in presentation to other cardiac disorders; therefore, clinicians in emergency settings must be efficient and effective in their diagnosis of this disorder on the basis of its distinct criteria. The current article uses most recent evidence to describe the etiology, pathophysiology, diagnosis, and recommended treatment for Takotsubo cardiomyopathy to support licensed independent practitioners in emergency departments in improving patient outcomes and reducing morbidity.
在急诊临床实践中,持照的独立从业者的任务是区分急性心脏表现。尽管 Takotsubo 心肌病在临床表现上与急性冠状动脉综合征相似,但它是一种独特的心脏疾病,其特征是心肌受到应激而呈气球样扩张。Takotsubo 心肌病也被称为心碎综合征,它最常发生在强烈的情绪或身体应激之后。随后的心脏收缩功能障碍使患者面临并发症的风险,包括急性心力衰竭、心源性休克、血栓栓塞、心律失常和左心室流出道梗阻。Takotsubo 心肌病在表现上与其他心脏疾病相似;因此,急诊环境中的临床医生必须根据其独特的标准高效且有效地诊断这种疾病。本文使用最新证据描述了 Takotsubo 心肌病的病因、病理生理学、诊断和推荐治疗方法,以支持急诊科持照的独立从业者改善患者预后并降低发病率。