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一名65岁女性因情绪应激引发的应激性心肌病病例

A Case of Takotsubo Cardiomyopathy in a 65-Year-Old Woman Triggered by Emotional Stress.

作者信息

Bader Malak, Mubarak Manar, Ali Sara, Hasan Zahra, Alsudairy Njood

机构信息

General Practice, Salmaniya Medical Complex, Manama, BHR.

College of Medicine, Wenzhou Medical University, Wenzhou, CHN.

出版信息

Cureus. 2024 Nov 12;16(11):e73533. doi: 10.7759/cureus.73533. eCollection 2024 Nov.

Abstract

Takotsubo cardiomyopathy (TCM), also known as stress-induced cardiomyopathy or "broken heart syndrome," is a transient cardiac condition that often mimics acute coronary syndrome (ACS) but lacks obstructive coronary artery disease. TCM primarily affects postmenopausal women and is often precipitated by physical or emotional stress. This report presents a case of TCM in a 65-year-old woman, emphasizing the diagnostic challenges and clinical management required to distinguish TCM from ACS. A 65-year-old woman presented to the emergency department with sudden chest pain and dyspnea following a recent emotional stressor. Her initial evaluation, including an ECG showing ST-segment elevation and mildly elevated troponin, suggested ACS. However, coronary angiography revealed no significant stenosis, and echocardiography demonstrated apical ballooning with preserved basal segment function, confirming a diagnosis of TCM. She was treated supportively with beta-blockers and an ACE inhibitor. Her hospital course was stable, and follow-up echocardiography showed normalization of left ventricular function, consistent with full recovery. This case contributes to the understanding of TCM, emphasizing the need for awareness in clinical practice to promptly diagnose and manage TCM effectively. Enhanced recognition of its triggers, pathophysiology, and diagnostic criteria can improve patient outcomes and reduce the risk of recurrence.

摘要

应激性心肌病(TCM),也被称为应激性心肌病或“心碎综合征”,是一种短暂的心脏疾病,常酷似急性冠状动脉综合征(ACS),但不存在阻塞性冠状动脉疾病。应激性心肌病主要影响绝经后女性,常由身体或情绪应激诱发。本报告介绍了一例65岁女性的应激性心肌病病例,强调了将应激性心肌病与急性冠状动脉综合征区分开来所需面对的诊断挑战和临床管理。一名65岁女性在近期经历情绪应激源后,因突发胸痛和呼吸困难就诊于急诊科。她的初步评估,包括心电图显示ST段抬高和肌钙蛋白轻度升高,提示为急性冠状动脉综合征。然而,冠状动脉造影显示无明显狭窄,超声心动图显示心尖部气球样变且基底节段功能保留,确诊为应激性心肌病。她接受了β受体阻滞剂和血管紧张素转换酶抑制剂的支持治疗。她的住院过程平稳,随访超声心动图显示左心室功能恢复正常,提示完全康复。该病例有助于加深对应激性心肌病的理解,强调在临床实践中需要提高认识,以便及时有效地诊断和管理应激性心肌病。增强对其触发因素、病理生理学和诊断标准的认识可改善患者预后并降低复发风险。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8a05/11638468/77aac0362a66/cureus-0016-00000073533-i01.jpg

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