Fazzini Luca, Marchetti Maria Francesca, Biddau Mattia, Aste Francesca, Maiani Silvia, Montisci Roberta
Clinical Cardiology Unit, AOU of Cagliari, Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy.
Eur J Case Rep Intern Med. 2022 Nov 8;9(11):003572. doi: 10.12890/2022_003572. eCollection 2022.
Takotsubo syndrome (TTS) is usually caused by physical or emotional negative stressors. Sometimes positive emotions trigger a rare form of Takotsubo syndrome, called the "happy heart" syndrome. We discuss the management of a 52-year-old female with happy heart syndrome, the differences between these stress cardiomyopathies and the relationship with hyperthyroidism.
The happy heart syndrome is less common than other stress cardiomyopathies but emergency doctors, cardiologists and all specialists in internal medicine should take into account this cardiomyopathy, which occurs in patients with previous positive emotions. It is triggered by opposite stressors to Takotsubo syndrome and sometimes it may be misdiagnosed. Beyond triggers it has some different clinical features, and the management is similar. It is a rare disease, and is therefore underdiagnosed.Everybody experiences positive emotions in life but only a small percentage develop stress cardiomyopathy. A susceptibility is needed to trigger these cardiomyopathies such as hyperthyroidism, which has to be promptly treated with an endocrinologist's help.In clinical practice it is common to diagnose stress cardiomyopathies without following up the patients. We need to follow up these patients especially looking for concomitant conditions such as hyperthyroidism or hypersympathetic activity, which could present during follow-up.
应激性心肌病（TTS）通常由身体或情绪方面的负面应激源引起。有时积极情绪会引发一种罕见的应激性心肌病，称为“开心心脏”综合征。我们讨论了一名患有开心心脏综合征的52岁女性的治疗，这些应激性心肌病之间的差异以及与甲状腺功能亢进症的关系。
开心心脏综合征比其他应激性心肌病少见，但急诊医生、心脏病专家和所有内科专科医生都应考虑到这种心肌病，它发生在有过积极情绪的患者身上。它由与应激性心肌病相反的应激源触发，有时可能会被误诊。除了触发因素外，它还有一些不同的临床特征，治疗方法相似。这是一种罕见疾病，因此诊断不足。每个人在生活中都会经历积极情绪，但只有一小部分人会发展为应激性心肌病。需要一种易感性来触发这些心肌病，比如甲状腺功能亢进症，必须在内分泌科医生的帮助下及时治疗。在临床实践中，诊断应激性心肌病后不随访患者很常见。我们需要对这些患者进行随访，尤其要寻找如甲状腺功能亢进症或交感神经过度活跃等可能在随访期间出现的伴随病症。
