Takotsubo Cardiomyopathy Associated with Jet-Lag Syndrome in a Taiwanese Elderly Woman-A Case Report and Literatures Review

酒壺狀心肌病變在台灣仍屬罕見。吾等報告一位74歲台灣人之女性案例。病患發作之一週前由旅居之海外歸國，發生持續、嚴重之時差症候群。她在發作前有呼吸道感染合併氣喘惡化，在喝下三杯咖啡及洗三溫暖一小時多以後胸痛發作。住院時，心電圖的第Ⅱ、Ⅲ、aVF及V3-6導程有ST節段上昇，而心肌酶只有少許上昇。發作當天心臟超音波檢查有左心室收縮期之廣範圍心尖部球狀變化。第二天當胸痛仍持續且心電圖仍呈ST節段上昇時進行冠狀動脈攝影，發現冠狀動脈尚稱正常。心電圖第三天出現反向T波；6個月後心電圖及左心室異常現象完全恢復正常。此一新型心臟症候群之誘因被推測因病人之左心室心尖部有較多交感神經之分佈，當有急性及嚴重之壓力發生時導致心肌交感神經之活化有關。

關鍵字

無資料

並列摘要

Takotsubo cardiomyopathy (CM) is still very rare in Taiwan. A 74-year-old Taiwanese woman came back from abroad for one week and suffered from a persisting and severe jet lag with sleep disturbance. She had a cold and experienced exacerbated bronchial asthma 3 days before the attack. She presented with sudden onset of chest pain after drinking 3 cups of coffee and taking a sauna for more than one hour. Upon admission, electrocardiogram (ECG) showed ST-segment elevation in leads Ⅱ, Ⅲ aVF, and V3-6 while cardiac enzymes reported minimal elevation. Echocardiogram showed apical ballooning and basal hyperkinesias of the left ventricle (LV) in systole. Coronary angiogram on the second day read normal when ST-segment continued to elevate with ongoing chest pain. Negative T wave developed 3 days later. The ECG abnormality and LV dysfunction completely disappeared 6 months later. We diagnosed the case as Takotsubo CM. The activated myocardial adrenergic nervous system stimulated by acute and marked stress in this patient with more adrenergic innervations distributed in apex of LV might be the trigger for this novel cardiac syndrome.

並列關鍵字

Takotsubo cardiomyopathy ； ampulla cardiomyopathy ； apical ballooning

國際替代計量

Takotsubo Cardiomyopathy Associated with Jet-Lag Syndrome in a Taiwanese Elderly Woman-A Case Report and Literatures Review

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