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一例复发性 Takotsubo 心肌病合并血栓栓塞的罕见病例。

A Rare Case of Recurrent Takotsubo Cardiomyopathy Complicated by Thromboemboli.

机构信息

BronxCare Health System, NY, USA.

Mount Sinai Morningside and BronxCare Health System, NY, USA.

出版信息

J Investig Med High Impact Case Rep. 2024 Jan-Dec;12:23247096241257394. doi: 10.1177/23247096241257394.

Abstract

Takotsubo syndrome (TTS) is a transient ventricular dysfunction with apical ballooning triggered by emotional and/or physical stress. A few risk factors have been observed in patients with recurrent TTS, for example, excessive sympathetic stimuli, medications, stress, and tumors. Clinical features can vary from chest pain to overt hemodynamic instability. Diagnosis requires both electrocardiographic features and invasive imaging such as angiography to rule out other causes of cardiomyopathy prior to diagnosis. In addition, renal infarcts presenting as a complication of TTS are relatively uncommon. In this case report, we discuss the case of a 61-year-old African American woman with a prior history of TTS being managed for abdominal pain who developed a recurrence of the TTS during the hospital course. Prompt diagnosis and management of the condition is crucial to improve outcomes especially in patients with thromboembolic phenomenon or hemodynamic instability. Further large-scale studies are warranted to determine outcomes of patients with recurrent Takotsubo cardiomyopathy with thromboembolic phenomenon.

摘要

心尖球囊综合征(TTS)是一种短暂性心室功能障碍,由情绪和/或身体应激引发的心室心尖部气球样变。一些复发性 TTS 患者存在一些危险因素,例如过度的交感神经刺激、药物、应激和肿瘤。临床特征从胸痛到明显的血流动力学不稳定不等。诊断需要心电图特征和侵入性成像(如血管造影),在诊断之前排除其他心肌病的原因。此外,肾梗死作为 TTS 的并发症相对少见。在本病例报告中,我们讨论了一位 61 岁的非裔美国妇女的病例,她曾患有 TTS,并接受了腹痛的治疗,在住院期间复发了 TTS。及时诊断和治疗该疾病对于改善预后至关重要,尤其是对于有血栓栓塞现象或血流动力学不稳定的患者。需要进一步的大规模研究来确定有血栓栓塞现象的复发性心尖球囊综合征患者的结局。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/54a8/11131386/bc20e5747178/10.1177_23247096241257394-fig1.jpg

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