A Man with Transient Left Ventricular Apical Ballooning Syndrome (Takotsubo Cardiomyopathy) Mimicking Acute Myocardial Infarctionin

暫時性左心室心尖球狀突出症候群（Takotsubo 肌病變）－急性心肌梗塞的模仿者

許振東(Chen-Tung Hsu) ； 張瑞月(Rei-Yeuh Chang) ； 陳政康(Cheng-Kang Chen)

《重症醫學雜誌》 10卷3期 (2009/09) Pp. 261-267

摘要

暫時性左心室心尖球狀突出症候群是一個最近被熱烈討論的心臟疾病。它的臨床表徵類似急性心肌梗塞，包括胸痛或呼吸困難、心電圖變化及輕微心臟酵素升高，但是，冠狀動脈無阻塞的情形。我們報告一位63歲男士，他的臨床症狀是漸漸加劇的下背痛，伴隨呼吸困難及胸悶。他最先被當成急性心肌梗塞來治療，然而，冠狀動脈無阻塞的情形，且左心室攝影發現有心尖球狀突出的現象。一個月後，追蹤心臟超音波發現左心室收縮功能完全正常。暫時性左心室心尖球狀突出症候群應該包含於急性心肌梗塞的鑑別診斷，尤其是有壓力誘發因子的病人。

關鍵字

Takotsubo心肌病變 ； 暫時性左心室心尖球狀突出症候群 ； 急性心肌梗塞

並列摘要

Transient left ventricular (LV) apical ballooning syndrome is a recently described entity characterized by chest symptoms associated with electrocardiographic changes and mild elevation of cardiac enzymes. The clinical presentation mimics acute myocardial infarction, but these patients have no significant stenosis of the coronary artery. We describe a 63-year-old man with dyspnea and chest tightness which occurred after progressive lower back pain. He was diagnosed and managed as a case of acute myocardial infarction initially. Apical akinesis with ballooning was noted during left ventriculography. However, coronary angiography did not show obstructive coronary stenosis. One month later, follow-up echocardiogram demonstrated complete resolution of the LV wall abnormalities. Transient LV apical ballooning syndrome should be included in the differential diagnosis of patients with an acute myocardial infarction, especially following a stressful trigger.

並列關鍵字

Takotsubo cardiomyopathy ； Transient left ventricular apical ballooning ； Acute myocardial infarction