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导致心原性休克的对立因素：Takotsubo 心肌病中的左心室流出道梗阻、严重二尖瓣反流和左心室功能障碍。

Opposing forces of cardiogenic shock: left ventricular outflow obstruction, severe mitral regurgitation, and left ventricular dysfunction in Takotsubo cardiomyopathy.

机构信息

Heart and Vascular Center, Dartmouth-Hitchcock Medical Center, Lebanon, NH, USA.

出版信息

ESC Heart Fail. 2022 Aug;9(4):2719-2723. doi: 10.1002/ehf2.13936. Epub 2022 May 6.

DOI:10.1002/ehf2.13936
PMID:35521673
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9288749/
Abstract

Rates of stress (Takotsubo) cardiomyopathy have increased during the coronavirus pandemic due to social stressors, even in patients who are not infected with the virus. At times, Takotsubo cardiomyopathy (TC) may present as cardiogenic shock. Herein, we present a case during the pandemic of shock from TC secondary to left ventricular outflow tract obstruction (LVOTO), mitral regurgitation (MR), and left ventricular (LV) dysfunction. The contrasting management strategy of LVOTO, MR, and LV failure was cause for clinical challenge, and we highlight the balance of treating these opposing forces.

摘要

由于社会压力因素，即使在未感染病毒的患者中，冠状病毒大流行期间应激（Takotsubo）心肌病的发病率也有所增加。有时，Takotsubo 心肌病（TC）可能表现为心源性休克。在此，我们介绍了一例在大流行期间因左心室流出道梗阻（LVOTO）、二尖瓣反流（MR）和左心室（LV）功能障碍继发 TC 导致休克的病例。LVOTO、MR 和 LV 衰竭的对比治疗策略带来了临床挑战，我们强调了治疗这些对立力量的平衡。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/36ff/9288749/254311437d30/EHF2-9-2719-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/36ff/9288749/204ae88eb8e4/EHF2-9-2719-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/36ff/9288749/4f72b85b0ad9/EHF2-9-2719-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/36ff/9288749/254311437d30/EHF2-9-2719-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/36ff/9288749/204ae88eb8e4/EHF2-9-2719-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/36ff/9288749/4f72b85b0ad9/EHF2-9-2719-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/36ff/9288749/254311437d30/EHF2-9-2719-g002.jpg

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本文引用的文献

1
Dynamic left ventricular outflow tract obstruction in Takotsubo cardiomyopathy resulting in cardiogenic shock.应激性心肌病导致的心源性休克中的动态左心室流出道梗阻。
BMJ Case Rep. 2021 Mar 24;14(3):e240010. doi: 10.1136/bcr-2020-240010.
2
Comparison of Outcomes in Patients With Takotsubo Syndrome With-vs-Without Cardiogenic Shock.比较伴有和不伴有心原性休克的 Takotsubo 综合征患者的结局。
Am J Cardiol. 2020 Dec 1;136:24-31. doi: 10.1016/j.amjcard.2020.09.014. Epub 2020 Sep 15.
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Clinical outcomes of Β-blocker therapy in cocaine-associated heart failure.
Β-受体阻滞剂治疗可卡因相关性心力衰竭的临床疗效。
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Beta-blockers for chest pain associated with recent cocaine use.用于治疗近期使用可卡因所致胸痛的β受体阻滞剂。
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Natural history and expansive clinical profile of stress (tako-tsubo) cardiomyopathy.应激（心碎）心肌病的自然病史和广泛的临床表现。
J Am Coll Cardiol. 2010 Jan 26;55(4):333-41. doi: 10.1016/j.jacc.2009.08.057.