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意外的心痛：食管胃十二指肠镜检查诱发的应激性心肌病

Unexpected Heartbreak: Takotsubo Cardiomyopathy Induced by Esophagogastroduodenoscopy.

作者信息

Abouzeid Wassim, Haddad Ahmad, Kloub Mohammad, Abu Ruman Yazeed, Patel Kinjal, Correia Joaquim

机构信息

Internal Medicine, Saint Michael's Medical Center, Newark, New Jersey.

Cardiology Department, Saint Michael's Medical Center, Newark, New Jersey.

出版信息

Tex Heart Inst J. 2025 May 23;52(1):e258558. doi: 10.14503/THIJ-25-8558. eCollection 2025 Jan-Jun.

DOI:10.14503/THIJ-25-8558
PMID:40415869
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12102090/
Abstract

Takotsubo cardiomyopathy (stress cardiomyopathy, or broken-heart syndrome), characterized by reversible left ventricular dysfunction without clinically significant coronary artery obstruction, is rare but has been more commonly reported recently. Esophagogastroduodenoscopy as a cause of takotsubo cardiomyopathy remains exceedingly rare. The case report of an 84-year-old female patient with a complex medical history who had acute stress cardiomyopathy following esophagogastroduodenoscopy, which required prolonged hospitalization and hemodynamic support, is presented. This case emphasizes the importance of recognizing and considering this uncommon pathology and its complications in differential diagnosis. Diagnostic modalities and treatment options for this condition are also discussed.

摘要

应激性心肌病（应激性心肌病，或心碎综合征），其特征为可逆性左心室功能障碍且无临床显著冠状动脉阻塞，较为罕见，但近年来报道更为常见。食管胃十二指肠镜检查作为应激性心肌病的病因仍然极为罕见。本文报告了一例84岁女性患者，其有复杂病史，在接受食管胃十二指肠镜检查后发生急性应激性心肌病，需要长期住院和血流动力学支持。该病例强调了在鉴别诊断中认识和考虑这种罕见病理及其并发症的重要性。还讨论了这种疾病的诊断方法和治疗选择。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6235/12102090/f49358813332/i1526-6702-52-1-e258558-f08.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6235/12102090/df3d3d63dd79/i1526-6702-52-1-e258558-f01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6235/12102090/92400518ca46/i1526-6702-52-1-e258558-f02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6235/12102090/1e14a2d7d63f/i1526-6702-52-1-e258558-f03.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6235/12102090/c0f4eac61bca/i1526-6702-52-1-e258558-f04.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6235/12102090/48df485f3f2f/i1526-6702-52-1-e258558-f05.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6235/12102090/5a53bd65a707/i1526-6702-52-1-e258558-f06.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6235/12102090/94991d924e9e/i1526-6702-52-1-e258558-f07.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6235/12102090/f49358813332/i1526-6702-52-1-e258558-f08.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6235/12102090/df3d3d63dd79/i1526-6702-52-1-e258558-f01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6235/12102090/92400518ca46/i1526-6702-52-1-e258558-f02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6235/12102090/1e14a2d7d63f/i1526-6702-52-1-e258558-f03.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6235/12102090/c0f4eac61bca/i1526-6702-52-1-e258558-f04.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6235/12102090/48df485f3f2f/i1526-6702-52-1-e258558-f05.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6235/12102090/5a53bd65a707/i1526-6702-52-1-e258558-f06.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6235/12102090/94991d924e9e/i1526-6702-52-1-e258558-f07.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6235/12102090/f49358813332/i1526-6702-52-1-e258558-f08.jpg

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本文引用的文献

1
Takotsubo cardiomyopathy after an upper and lower endoscopy: a case report and review of the literature.上下消化道内镜检查后发生的应激性心肌病：一例病例报告及文献复习
J Med Case Rep. 2019 Mar 25;13(1):81. doi: 10.1186/s13256-019-2014-y.
2
Takotsubo Cardiomyopathy: Case Series and Literature Review.应激性心肌病：病例系列及文献综述。
Cureus. 2016 Jun 20;8(6):e649. doi: 10.7759/cureus.649.
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Current state of knowledge on Takotsubo syndrome: a Position Statement from the Taskforce on Takotsubo Syndrome of the Heart Failure Association of the European Society of Cardiology.
Takotsubo 综合征的现有知识状况：欧洲心脏病学会心力衰竭协会 Takotsubo 综合征工作组的立场声明。
Eur J Heart Fail. 2016 Jan;18(1):8-27. doi: 10.1002/ejhf.424. Epub 2015 Nov 9.
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Apical and midventricular transient left ventricular dysfunction syndrome (tako-tsubo cardiomyopathy): frequency, mechanisms, and prognosis.心尖部和心室中部短暂性左心室功能障碍综合征（应激性心肌病）：发生率、机制及预后
Chest. 2007 Sep;132(3):809-16. doi: 10.1378/chest.07-0608. Epub 2007 Jun 15.
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Neurohumoral features of myocardial stunning due to sudden emotional stress.突发情绪应激所致心肌顿抑的神经体液特征
N Engl J Med. 2005 Feb 10;352(6):539-48. doi: 10.1056/NEJMoa043046.