Shah Binoy K, Fiore Nicolas F, Fuentes Fernando J
Internal Medicine, University of Nevada, Reno, Reno, USA.
Family Medicine, Renown Regional Medical Center, Reno, USA.
Cureus. 2023 Jul 21;15(7):e42279. doi: 10.7759/cureus.42279. eCollection 2023 Jul.
Takotsubo cardiomyopathy (TCM) is a reversible syndrome that resembles a myocardial infarction but without typical coronary stenosis and with an apical "ballooning" image present on an echocardiogram. Multiple triggers have been linked to TCM but rarely, acute severe hypoglycemia. This is a case of a 39-year-old woman who was brought to the emergency department after being found unresponsive at home. She was severely hypoglycemic with a glucose of 18 mg/dL and suspected to have sulfonylurea intoxication. The patient was intubated and transferred to our ICU from an outside facility for a higher level of care. The patient was noted to have an elevated troponin and the initial echocardiogram demonstrated TCM. The patient remained persistently hypoglycemic, despite continuous dextrose infusion and glucagon treatment. Stress dose steroids were added with the eventual resolution of hypoglycemia. A repeat echocardiogram demonstrated the resolution of TCM.
应激性心肌病（TCM）是一种可逆性综合征，类似于心肌梗死，但无典型的冠状动脉狭窄，且超声心动图显示有心尖部“球囊样”影像。多种诱因与TCM有关，但急性严重低血糖很少与之相关。这是一例39岁女性病例，在家中被发现无反应后被送至急诊科。她血糖严重降低，血糖值为18mg/dL，怀疑有磺脲类药物中毒。患者行气管插管，并从外部机构转至我们的重症监护病房接受更高水平的治疗。患者肌钙蛋白升高，初次超声心动图显示为应激性心肌病。尽管持续输注葡萄糖和使用胰高血糖素治疗，患者血糖仍持续降低。加用应激剂量的类固醇后，低血糖最终得以缓解。复查超声心动图显示应激性心肌病已缓解。
