Khan Muhammad A, Howell Alexander, Pham Thuy, Guzman Nilmarie
Internal Medicine, Orange Park Medical Center, Orange Park, USA.
Cardiology, Orange Park Medical Center, Orange Park, USA.
Cureus. 2021 Jun 5;13(6):e15469. doi: 10.7759/cureus.15469. eCollection 2021 Jun.
Takotsubo cardiomyopathy (TTC) is a reversible form of myocardial injury characterized by transient systolic and diastolic dysfunction secondary to regional left ventricle (LV) wall motion abnormalities. We present a case of a rare variant of TTC, termed reverse TTC (rTTC), involving basal hypokinesis with apical hyperkinesis accounting for less than 5% of identified cases of TTC. Our patient is a 49-year-old Hispanic female who presented for evaluation of dyspnea. She was diagnosed with acute asthma exacerbation. The patient admitted to more frequent use of her albuterol rescue inhaler. Over the course of her hospitalization the patient had elevation of Troponin I and underwent an echocardiogram and coronary angiogram, which revealed the diagnosis of rTTC in the setting of inhaled beta agonist overuse for acute asthma exacerbation. Our case highlights the importance of adequately managing asthma to prevent exacerbation and overuse of inhaled sympathomimetic agents in an effort to decrease the incidence of TTC in the asthmatic population.
应激性心肌病（TTC）是一种可逆性心肌损伤形式，其特征为继发于局部左心室（LV）壁运动异常的短暂收缩和舒张功能障碍。我们报告一例罕见的TTC变异型，称为反向TTC（rTTC），其表现为基底节运动减弱伴心尖运动增强，在已确诊的TTC病例中占比不到5%。我们的患者是一名49岁的西班牙裔女性，因呼吸困难前来就诊。她被诊断为急性哮喘加重。患者承认更频繁地使用沙丁胺醇急救吸入器。在住院期间，患者肌钙蛋白I升高，并接受了超声心动图和冠状动脉造影检查，结果显示在急性哮喘加重时因过度使用吸入性β受体激动剂而诊断为rTTC。我们的病例强调了充分控制哮喘以预防加重以及避免过度使用吸入性拟交感神经药物的重要性，以期降低哮喘患者中TTC的发病率。
