Basnet Arjun, Sharma Nava R, Lamichhane Saral, Tiwari Kripa, Varghese Jeffy, Kansakar Sajog, Gautam Sudarshan
Maimonides Medical Center, Brooklyn, USA.
Manipal College of Medical Sciences.
Ann Med Surg (Lond). 2023 Jun 17;85(7):3744-3747. doi: 10.1097/MS9.0000000000000965. eCollection 2023 Jul.
Reverse takotsubo syndrome, a variant of takotsubo cardiomyopathy, is an acute left ventricular failure characterized by the basal akinesis/hypokinesis associated with apical hyperkinesis. Its presentation is similar to that of the acute coronary syndrome.
The authors present a case of a 49-year-old woman, a vice principal at a local school with a history of hypertension, who was brought to our center after she collapsed while giving a graduation speech. Reverse takotsubo was a presumed diagnosis after we ruled out other differentials.
The pathophysiology of reverse takotsubo syndrome is poorly understood. It might be due to a different pattern of catecholamine-mediated myocardial dysfunction than classic takotsubo cardiomyopathy. It is often associated with physical and/or emotional stressors.
Supportive treatment and identification and prevention of triggers can reduce the recurrence of reverse takotsubo cardiomyopathy. Physicians should be aware of various triggers for this condition.
反向性应激性心肌病是应激性心肌病的一种变体,是一种急性左心室衰竭,其特征为基底段运动减弱/运动功能减退伴心尖段运动增强。其表现与急性冠状动脉综合征相似。
作者报告一例49岁女性病例,该女性是当地一所学校的副校长,有高血压病史,在毕业典礼演讲时晕倒后被送至本中心。排除其他鉴别诊断后,推测诊断为反向性应激性心肌病。
反向性应激性心肌病的病理生理学尚不清楚。它可能是由于儿茶酚胺介导的心肌功能障碍模式与经典应激性心肌病不同所致。它常与身体和/或情绪应激源相关。
支持性治疗以及识别和预防触发因素可降低反向性应激性心肌病的复发率。医生应了解这种疾病的各种触发因素。