Barmore Walker, Patel Himax, Harrell Sean, Garcia Daniel, Calkins Joe B
Department of Internal Medicine, Augusta University Medical Center, Augusta, GA 30912, United States.
Department of Cardiovascular Medicine, Augusta University Medical Center, Augusta, GA 30912, United States.
World J Cardiol. 2022 Jun 26;14(6):355-362. doi: 10.4330/wjc.v14.i6.355.
Takotsubo cardiomyopathy (TCM), also known as stress cardiomyopathy, occurs in the setting of catecholamine surge from an acute stressor. This cardiomyopathy mimics acute myocardial infarction in the absence of coronary disease. The classic feature of TCM is regional wall motion abnormalities with characteristic ballooning of the left ventricle. The etiology of the stressor is often physical or emotional stress, however iatrogenic causes of TCM have been reported in the literature. In our review, we discuss medications, primarily the exogenous administration of catecholamines, and a wide array of procedures with subsequent development of iatrogenic cardiomyopathy. TCM is unique in that it is transient and has favorable outcomes in most individuals. Classically, beta-blockers and ACE-inhibitors have been prescribed in individuals with cardiomyopathy; however, unique to TCM, no specific treatment is required other than temporary supportive measures as this process is transient. Additionally, no improvement in mortality or recurrence have been reported in patients on these drugs. The aim of this review is to elucidate on the iatrogenic causes of TCM, allowing for prompt recognition and management by clinicians.
应激性心肌病（TCM），也被称为应激性心肌病，发生于急性应激源导致儿茶酚胺激增的情况下。这种心肌病在无冠状动脉疾病时会模拟急性心肌梗死。应激性心肌病的典型特征是局部室壁运动异常以及左心室特征性的气球样变。应激源的病因通常是身体或情绪上的压力，然而文献中也报道过医源性应激性心肌病的病因。在我们的综述中，我们讨论了药物，主要是儿茶酚胺的外源性给药，以及一系列随后发生医源性心肌病的操作。应激性心肌病的独特之处在于它是短暂的，并且在大多数个体中预后良好。传统上，心肌病患者会使用β受体阻滞剂和血管紧张素转换酶抑制剂；然而，应激性心肌病的独特之处在于，除了临时支持措施外不需要特殊治疗，因为这个过程是短暂的。此外，使用这些药物的患者在死亡率或复发率方面并无改善。本综述的目的是阐明应激性心肌病的医源性病因，以便临床医生能够及时识别和处理。
