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心脏异常:胆囊切除术后的反向应激性心肌病

Cardiac Anomaly: Reverse Takotsubo Following Gallbladder Surgery.

作者信息

Aodish Sandres, Tam Ryan, Grain Modather, Fiema Bryan

机构信息

Surgery, Lake Erie College of Osteopathic Medicine, Erie, USA.

Internal Medicine, Lake Erie College of Osteopathic Medicine, Erie, USA.

出版信息

Cureus. 2024 Jul 24;16(7):e65297. doi: 10.7759/cureus.65297. eCollection 2024 Jul.

Abstract

Takotsubo cardiomyopathy is an acute but often reversible left ventricular dysfunction commonly triggered by emotional stress. There are multiple variants within the general condition; however, reverse Takotsubo cardiomyopathy is a rare variant of stress-induced cardiomyopathy affecting the basilar segment of the left ventricle. This commonly manifests in younger women with clinical presentations similar to acute coronary syndrome. Cases of postoperative reverse Takotsubo cardiomyopathy are limited in the current literature. Hence, we present an 81-year-old female with shortness of breath and chest pain with exertion following a recent laparoscopic cholecystectomy. Based on her symptoms during the presentation, troponin and beta-natriuretic peptide were obtained. Results demonstrated an elevation in both markers, raising concerns for possible acute coronary syndrome (ACS). The patient subsequently underwent a transthoracic echocardiogram (TTE), which demonstrated findings consistent with reverse Takotsubo cardiomyopathy (rTTC). Therefore, we present a unique case of an 81-year-old female presenting with rTTC following laparoscopic cholecystectomy.

摘要

应激性心肌病是一种急性但通常可逆的左心室功能障碍,常见于情绪应激诱发。在这一总体病症中有多种变体;然而,反向应激性心肌病是应激性心肌病的一种罕见变体,影响左心室基底段。这在年轻女性中较为常见,临床表现类似于急性冠脉综合征。目前文献中关于术后反向应激性心肌病的病例有限。因此,我们报告一例81岁女性,在近期腹腔镜胆囊切除术后出现劳力性呼吸困难和胸痛。根据其就诊时的症状,检测了肌钙蛋白和脑钠肽。结果显示这两种标志物均升高,引发了对可能的急性冠脉综合征(ACS)的担忧。患者随后接受了经胸超声心动图(TTE)检查,结果显示与反向应激性心肌病(rTTC)相符。因此,我们报告了一例独特的81岁女性在腹腔镜胆囊切除术后出现rTTC的病例。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3ce6/11346746/de35fcc4055c/cureus-0016-00000065297-i01.jpg

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