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首页> 外文期刊>Journal of Medical Case Reports >Recurrent takotsubo cardiomyopathy in the setting of transient neurological symptoms: a case report
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Recurrent takotsubo cardiomyopathy in the setting of transient neurological symptoms: a case report

机译：暂时性神经系统症状复发的takotsubo心肌病：一例报告

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Introduction First described in Japan, takotsubo cardiomyopathy is increasingly becoming recognized worldwide as a cause of sudden and reversible diminished left ventricular function characterized by left apical ballooning and hyperkinesis of the basal segments, often with symptoms mimicking a myocardial infarction. Associated with physical or emotional stress, its exact pathogenesis has not been established, though evidence supports a neurohumoral etiology. Additionally, recurrence of this condition is rare. In this report, we present a rare case of recurrent takotsubo cardiomyopathy in a post-menopausal woman who presented with transient neurological complaints on both occasions. Case presentation We present a rare case of a 76-year-old Caucasian woman with no history of congestive heart failure who presented to our emergency department twice with transient neurological complaints. On the first occasion, she was found to have transient aphasia which resolved within 24 hours, yet during that period she also developed symptoms of congestive heart failure and was noted to have a new, significantly depressed ejection fraction with apical akinesis and possible apical thrombus. One month after her presentation a repeat echocardiogram revealed complete resolution of all wall motion abnormalities and a return to baseline status. Seven months later she presented with ataxia, was diagnosed with vertebrobasilar insufficiency, and again developed symptoms and echocardiography findings similar to those of her first presentation. Once again, at her one-month follow-up examination, all wall motion abnormalities had completely resolved and her ejection fraction had returned to normal. Conclusion Though the exact etiology of takotsubo cardiomyopathy is unclear, a neurohumoral mechanism has been proposed. Recurrence of this disorder is rare, though it has been reported in patients with structural brain abnormalities. This report is the first to describe recurrent takotsubo cardiomyopathy in a patient with transient neurological symptoms. In our patient, as expected in patients with this condition, complete resolution of all left ventricular abnormalities occurred within a short period of time. It is important for clinicians to be aware of this increasingly recognized syndrome, including its association with recurrence, especially in the clinical setting of neurologic dysfunction.
机译：引言在日本，takotsubo心肌病首先被描述为一种导致左心室功能突然和可逆性减弱的病因，其特征是左心尖气球膨胀和基底节运动亢进，通常表现为模仿心肌梗塞的症状。尽管有证据支持神经体液病因，但与身体或情绪压力有关，其确切发病机制尚未确定。另外，这种情况的复发很少。在本报告中，我们介绍了绝经后妇女中反复出现的takotsubo心肌病的罕见病例，这两次患者均出现短暂的神经系统不适。病例介绍我们介绍了一个罕见病例，其中一名76岁的白人妇女没有充血性心力衰竭病史，她曾两次因短暂的神经系统疾病向我们的急诊科就诊。第一次发现她患有短暂性失语症，可在24小时内消退，但在此期间，她还出现了充血性心力衰竭症状，并被发现有新的明显的射血分数降低，并伴有心尖运动不全和可能的心尖血栓。在她就诊后的一个月，重复进行的超声心动图检查显示所有壁运动异常均已完全解决，并恢复到基线状态。七个月后，她出现共济失调，被诊断为椎基底动脉供血不足，并再次出现与首次出现类似的症状和超声心动图检查结果。再次进行了为期一个月的随访检查，所有室壁运动异常均已完全消除，其射血分数已恢复正常。结论尽管takotsubo心肌病的确切病因尚不清楚，但已提出了神经体液的机制。尽管有结构性脑部异常的患者已有报道，这种疾病的复发很少见。该报告首次描述了短暂性神经系统症状患者复发性takotsubo心肌病。在我们的患者中，正如在这种情况下所期望的那样，所有左心室异常的完全解决都在很短的时间内发生。对于临床医生而言，重要的是要意识到这种日益被认可的综合症，包括其与复发的关联，尤其是在神经功能障碍的临床环境中。

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