Department of Cardiology, Hacettepe University Faculty of Medicine, Ankara, Türkiye.
Turk Kardiyol Dern Ars. 2024 Sep;52(6):455-459. doi: 10.5543/tkda.2023.93429.
Takotsubo cardiomyopathy (TCM) is characterized by transient left ventricular dysfunction, diagnosed via echocardiography or left ventriculography. In most cases, TCM involves an emotional, physical, or combined trigger. Acute coronary syndrome is one of the most frequent misdiagnoses in TCM patients due to electrocardiogram (ECG) abnormalities and elevated cardiac biomarkers. Typically, coronary angiography reveals no stenosis or occlusion of the coronary arteries. Hypertrophic cardiomyopathy (HCM) is a distinct pathology characterized by a hypertrophied left ventricle with various phenotypes. However, some reports have described TCM cases mimicking obstructive-type HCM in some patients. We present a case of a female patient diagnosed with TCM based on clinical, laboratory, and imaging tests. Differentiating TCM from HCM was challenging due to ventriculography and echocardiography findings, as hyperdynamic contraction of the basal segments of the left ventricle caused an increased left ventricular outflow tract (LVOT) gradient and severe mitral valve regurgitation. Detailed evaluation and close echocardiographic follow-up are essential in such rare cases.
心尖球囊样综合征（Takotsubo 心肌病）的特征为短暂性左心室功能障碍，通过超声心动图或左心室造影进行诊断。在大多数情况下，Takotsubo 心肌病涉及情绪、身体或混合触发因素。由于心电图（ECG）异常和心脏生物标志物升高，急性冠状动脉综合征是 Takotsubo 心肌病患者最常见的误诊之一。通常，冠状动脉造影显示冠状动脉无狭窄或闭塞。肥厚型心肌病（Hypertrophic cardiomyopathy，HCM）是一种明显的病理学特征，表现为左心室肥厚伴多种表型。然而，一些报告描述了一些患者中 Takotsubo 心肌病病例模拟阻塞型 HCM。我们报告了一例女性患者，根据临床、实验室和影像学检查诊断为 Takotsubo 心肌病。由于心室造影和超声心动图的发现，Takotsubo 心肌病与 HCM 的鉴别具有挑战性，因为左心室基底段的高动力收缩导致左心室流出道（LVOT）梯度增加和严重的二尖瓣反流。在这种罕见情况下，详细的评估和密切的超声心动图随访至关重要。
