Moady Gassan, Rubinstein Gal, Mobarki Loai, Atar Shaul
Department of Cardiology, Galilee Medical Center, 2210001 Nahariya, Israel.
Azrieli Faculty of Medicine, Bar Ilan University, 1311502 Safed, Israel.
Rev Cardiovasc Med. 2022 Apr 8;23(4):131. doi: 10.31083/j.rcm2304131. eCollection 2022 Apr.
Takotsubo syndrome is an important condition to consider among patients with acute chest pain in the emergency room. It often mimics acute coronary syndrome since chest pain and ECG changes are key features in both conditions. The hallmark of takotsubo syndrome is transient left ventricular dysfunction (characterized by apical ballooning) followed by complete echocardiographic recovery in most cases. Although most patients exhibit a benign course, lethal complications may occur. The use of hand-held point-of-care focused cardiac ultrasound may be helpful for early identification of takotsubo syndrome and distinguishing it from acute coronary syndrome and other cardiovascular emergencies. Emergency room physicians should be familiar with typical and atypical presentations of takotsubo syndrome and its key electrocardiographic changes. The approach in the emergency room should be based on a combination the clinical presentation, ECG, and handheld echocardiography device findings, rather than a single electrocardiographic algorithm.
应激性心肌病是急诊室中急性胸痛患者需要考虑的重要病症。它常酷似急性冠脉综合征，因为胸痛和心电图改变是这两种病症的关键特征。应激性心肌病的标志是短暂性左心室功能障碍（以心尖部气球样变为特征），多数情况下随后超声心动图表现完全恢复。虽然大多数患者病程呈良性，但可能发生致命并发症。使用手持式即时心脏超声检查可能有助于早期识别应激性心肌病，并将其与急性冠脉综合征及其他心血管急症相鉴别。急诊室医生应熟悉应激性心肌病的典型和非典型表现及其关键心电图改变。急诊室的处理方法应基于临床表现、心电图及手持式超声心动图检查结果的综合判断，而非单一的心电图诊断标准。
