Clark Lindsey C, Khunger Arjun, Aji Walif
Department of Internal Medicine, Memorial Hospital West, GME Building, 703 North Flamingo Road, Pembroke Pines, FL, 33028, USA.
Department of Cardiology, Memorial Hospital West, Pembroke Pines, FL, USA.
Egypt Heart J. 2022 Oct 1;74(1):72. doi: 10.1186/s43044-022-00310-9.
Takotsubo cardiomyopathy (TCM) is a non-ischemic syndrome characterized by transient acute left ventricular dysfunction as evident on transthoracic echocardiography. It can often mimic myocardial ischemia and is characterized by the absence of angiographic evidence of obstructive coronary artery disease. Reports of Takotsubo syndrome in elderly with asthma exacerbations have been noted.
We describe a case of TCM in a 68-year-old female who presented with acute shortness of breath secondary to status asthmaticus. Her electrocardiogram showed ST segment elevations in multiple coronary artery distributions and mildly elevated troponin levels. Coronary angiography showed no significant stenosis of the coronary arteries with left ventriculography that showed systolic apical ballooning with a 10% ejection fraction, consistent with TCM.
Takotsubo syndrome should be considered in the differential diagnosis of patients presenting with status asthmaticus and elevated troponin levels on admission. Patients should be asked about the use of beta agonist prior to admission. A thorough literature review including a summary of 11 previously published case reports of TCM with acute asthma exacerbations has been presented.
应激性心肌病（TCM）是一种非缺血性综合征，其特征为经胸超声心动图显示短暂性急性左心室功能障碍。它常可模拟心肌缺血，且特征为无阻塞性冠状动脉疾病的血管造影证据。已有关于老年哮喘加重患者出现应激性心肌病综合征的报道。
我们描述了一例68岁女性的应激性心肌病病例，该患者因哮喘持续状态出现急性呼吸急促。她的心电图显示多个冠状动脉分布区域ST段抬高，肌钙蛋白水平轻度升高。冠状动脉造影显示冠状动脉无明显狭窄，左心室造影显示收缩期心尖部气球样变，射血分数为10%，符合应激性心肌病。
对于因哮喘持续状态入院且肌钙蛋白水平升高的患者，鉴别诊断时应考虑应激性心肌病。应询问患者入院前是否使用过β受体激动剂。本文对包括11例先前发表的应激性心肌病合并急性哮喘加重病例报告总结在内的文献进行了全面综述。
