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曲坦类药物诱发的应激性心肌病:一例报告

Triptan-induced takotsubo syndrome: a case report.

作者信息

Somers-Edgar Tiffany Joy, Shah Jignesh, Kueh Anthony, Kasargod Prabhakar Chethan

机构信息

Green Lane Cardiovascular Services, Auckland City Hospital; Te Whatu Ora, Health New Zealand, Te Toka Tumai, Auckland, New Zealand.

出版信息

Eur Heart J Case Rep. 2023 May 3;7(8):ytad221. doi: 10.1093/ehjcr/ytad221. eCollection 2023 Aug.

Abstract

BACKGROUND

Takotsubo syndrome (TS) is a clinical condition mimicking acute coronary syndrome characterized by reversible acute systolic dysfunction. TS is typically associated with a catecholaminergic surge resulting from physical or emotional stress while some pharmacologic agents may act as a trigger.

CASE SUMMARY

Here, we report a case of TS secondary to rizatriptan, used for treatment of acute migraine. A 67-year-old woman with a history of dyslipidemia, type II diabetes, and migraine was admitted with chest heaviness shortly after taking rizatriptan for migraine. Deepening T wave inversion was seen in multiple territories on electrocardiogram and hs-troponin T was elevated. Cardiac imaging including echocardiogram coronary angiography and cardiac magnetic resonance imaging was consistent with a diagnosis of TS.

DISCUSSION

In this case, there was no emotional trigger for TS described. Given the compelling temporal correlation between the onset of typical chest pain and medication use, a diagnosis of TS secondary to rizatriptan was made.

摘要

背景

应激性心肌病(TS)是一种临床症状类似急性冠状动脉综合征的疾病,其特征为可逆性急性收缩功能障碍。TS通常与因身体或情绪应激导致的儿茶酚胺激增有关,而一些药物制剂也可能成为触发因素。

病例摘要

在此,我们报告一例因利扎曲普坦用于治疗急性偏头痛而继发应激性心肌病的病例。一名有血脂异常、II型糖尿病和偏头痛病史的67岁女性,在服用利扎曲普坦治疗偏头痛后不久因胸部闷痛入院。心电图显示多个导联T波倒置加深,高敏肌钙蛋白T升高。包括超声心动图、冠状动脉造影和心脏磁共振成像在内的心脏影像学检查结果与应激性心肌病的诊断相符。

讨论

在该病例中,未描述有导致应激性心肌病的情绪触发因素。鉴于典型胸痛发作与用药之间存在明显的时间相关性,故诊断为利扎曲普坦继发的应激性心肌病。

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