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- Tako-tsubo Syndrome with Dynamic Left Ventricular Outflow Tract Obstruction and Mitral Regurgitation: A Case Report
- Takotsubo Cardiomyopathy Syndrome or Neurogenic Stunned Myocardium Induced by Acute Subarachnoid Hemorrhage: A Case Report and Discussion
- 章魚壺心肌症
- 急性冠心症?
- 章魚壺心肌症(Takotsubo Cardiomyopathy)
- 章魚壺心肌症
- 章魚壺心肌症
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題名 | Tako-tsubo Syndrome with Dynamic Left Ventricular Outflow Tract Obstruction and Mitral Regurgitation: A Case Report=章魚壺心肌症合併左心室出口阻塞及二尖瓣逆流--病例報告 |
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作者 | 洪啟盛; 陳明豐; Hung, Chi-sheng; Chen, Ming-fong; |
期刊 | 中華民國重症醫學雜誌 |
出版日期 | 20120300 |
卷期 | 13:1 2012.03[民101.03] |
頁次 | 頁54-58 |
分類號 | 415.3161 |
語文 | eng |
關鍵詞 | 章魚壺心肌症; 左心室出口阻塞; Tako-tsubo cardiomyopathy; Apical ballooning syndrome; LVOT obstruction; |
中文摘要 | 章魚壺心肌症臨床表現類似急性冠心症,包括急性胸痛, ST-T 節段動態變化及心肌損傷指標的上升。若合併局部心臟收縮功能不良(特別在左心室心尖)及正常的冠狀動脈則可診斷此疾病。章魚壺心肌症的發生原因及病理生理機轉目前仍未完全明瞭。目前有數種學說被提出,包括冠狀動脈痙攣、冠狀動脈微循環功能異常及血中兒茶酚胺激素過高,用來解釋此一症候。左心室出口壓力增加也在章魚壺心肌症的病患中被觀察到,也被提出用來解釋其病理生理機轉。我們報告一例章魚壺心肌症的病患合併有明顯增高的左心室出口壓力及動態的二尖瓣逆流,並討論左心室出口壓力增高在此症候群可能扮演的角色。心臟超音波檢查在此類病患為重要的診斷工具,並可能影響治療方向。 |
英文摘要 | Tako-tsubo syndrome is characterized by acute chest pain, dynamic ST-T change and elevated cardiac markers, mimicking acute coronary syndrome. Severe, but transient LV regional dysfunction, more commonly in apical area, and patent coronary arteries establish the clinical diagnosis. The underlying mechanism of this syndrome is not fully clarified. Coronary spasm, microcirculation dysfunction and catecholamine overload have been proposed as the possible causes of this syndrome. LV outflow tract obstruction has been reported as a possible contributor to this syndrome. We report a case of tako-tsubo syndrome with markedly increased LV outflow tract pressure gradient and dynamic mitral regurgitation. The possible role of LV outflow tract obstruction in the pathophysiologic process is discussed. Echocardiography is a useful tool to identify this abnormality and to guide the therapy. |
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