Gudenkauf Brent, Goetsch Michael R, Vakil Rachit M, Cingolani Oscar, Adamo Luigi
Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, United States.
Division of Cardiology, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, United States.
Front Cardiovasc Med. 2022 Jul 11;9:931070. doi: 10.3389/fcvm.2022.931070. eCollection 2022.
A growing body of evidence suggests that inflammation may play a key role in the development of Takotsubo stress cardiomyopathy. Here, we report the case of a 63-year-old woman who presented with chest pain and was diagnosed with this cardiomyopathy. After an initial improvement, the patient experienced a systemic inflammatory response of unclear origin and deteriorated rapidly into obstructive shock. Her presentation was considered consistent with cytokine storm. She was, therefore, treated with steroids with rapid improvement in her clinical picture. She relapsed after the taper. Endomyocardial biopsy soon after initiation of pulse dose steroids showed macrophage and lymphocytic infiltration. This case highlights the potential intimate connection between systemic inflammatory response and Takotsubo stress cardiomyopathy and contributes to the evolving understanding of inflammation in the pathogenesis of this disease.
越来越多的证据表明，炎症可能在应激性心肌病的发病过程中起关键作用。在此，我们报告一例63岁女性患者，该患者因胸痛就诊，被诊断为这种心肌病。在病情初步改善后，患者出现了原因不明的全身炎症反应，并迅速恶化为梗阻性休克。她的表现被认为与细胞因子风暴一致。因此，她接受了类固醇治疗，临床症状迅速改善。减量后病情复发。在开始使用脉冲剂量类固醇后不久进行的心内膜心肌活检显示有巨噬细胞和淋巴细胞浸润。该病例突出了全身炎症反应与应激性心肌病之间潜在的密切联系，并有助于加深对该疾病发病机制中炎症的理解。
