Potievskaya Vera, Khoronenko Victoria, Kononova Elena, Paderina Elena, Fashafsha Zaki, Kaprin Andrey
P. Hertsen Moscow Oncology Research Institute-Branch or the Federal State Budgetary Institution "National Medical Research Radiological Centre" of the Ministry of Health of the Russian Federation, Moscow, Russia.
Russian Medical Academy of Postgraduate Education of Federal Scientific and Clinical Center for Specialized Medical Assistance and Medical Technologies of the Federal Medical Biological Agency, Moscow, Russia.
Front Cardiovasc Med. 2025 Aug 4;12:1586353. doi: 10.3389/fcvm.2025.1586353. eCollection 2025.
We present a case of Takotsubo cardiomyopathy (TCM) in a young woman who has developed necrosis and perforation of the sigmoid intestine with a spontaneous opening of the abscess in the abdominal cavity, which caused purulent peritonitis. The patient underwent emergency surgical intervention. The postoperative period was complicated by a clinic of acute respiratory failure and bilateral pneumonia. In five days after surgery, the patient developed laboratory and instrumental signs of acute myocardial infarction. Changes similar to myocardial infarction appeared on electrocardiogram (ECG). Echocardiography revealed akinesis of the apical segments of the left ventricle and the ejection fraction of the left ventricle was reduced (LVEF) from 63 to 31%-35%. The level of NT-proBNP has increased significantly, but the level of troponin I increased to a lesser extent. Coronary angiography demonstrated normal arteries without any obstruction. As a result, a diagnosis Takotsubo cardiomyopathy caused by acute surgical pathology was made. In the future, the patient was discharged in a stable state. Subsequent echocardiography showed normalization of the systolic function of the left ventricle, the disappearance of ECG changes, and a decrease in the level of specific cardiomarkers.
我们报告一例年轻女性的Takotsubo心肌病(TCM),该患者出现乙状结肠坏死和穿孔,腹腔脓肿自发破溃,导致化脓性腹膜炎。患者接受了紧急手术干预。术后出现急性呼吸衰竭和双侧肺炎。术后五天,患者出现急性心肌梗死的实验室和影像学表现。心电图(ECG)出现类似心肌梗死的变化。超声心动图显示左心室心尖段运动减弱,左心室射血分数(LVEF)从63%降至31%-35%。NT-proBNP水平显著升高,但肌钙蛋白I水平升高幅度较小。冠状动脉造影显示动脉正常无阻塞。最终诊断为急性手术病理导致的Takotsubo心肌病。此后,患者病情稳定出院。后续超声心动图显示左心室收缩功能恢复正常,ECG变化消失,特异性心脏标志物水平降低。