压力诱导的心肌病伪装成急性ST段升高心肌梗塞心肌梗塞
Subash Nepal1, Dana Aiello2, Kamala Ojha3
1Internal Medicine, Upstate Medical University, Syracuse, USA.
Cureus
|August 23, 2023
概括
压力诱导的心肌病,一种由激素激增或创伤引发的心脏病,模仿急性冠状动脉综合征. 这一案例突出了72岁女性的呈现,强调了需要仔细诊断的需要.
科学领域:
- 心脏病学 心脏病学
- 内部医学 内部医学
背景情况:
- 心肌压力可以导致各种心血管并发症,压力诱导的心肌病是主要的表现.
- 由荷尔蒙过量,败血症,心动减速或创伤等因素引发的神经激素和神经质激素激增,是这种情况的基础.
- 压力诱导的心肌病症状,包括胸痛和心电图变化,类似于急性冠状动脉综合征,需要排除冠状动脉疾病.
研究的目的:
- 在一个72岁的女性中呈现一种压力诱导心肌病的病例.
- 为了说明压力诱导心肌病的诊断挑战和表现.
- 强调在疑似病例中排除冠状动脉疾病的重要性.
主要方法:
- 一个72岁的女性病例报告显示,她患有胸痛.
- 电心电图 (ECG) 显示ST升高和高水平的热素.
- 紧急心脏导管,左心室图和心声图以评估心脏功能和冠状动脉.
主要成果:
- 心脏导管检查显示了微不足道的冠状动脉疾病.
- 心声图显示左心室缩功能中度下降.
- 观察到与正常的基底收缩相一致的无动力-低动力中至偏心肌段,与压力诱导的心肌病相一致.
结论:
- 压力诱导的心肌病症可以呈现异常,即使没有明显的先前压力因素.
- 诊断依赖于排除冠状动脉疾病和成像上的特征性发现.
- 这一案例强调了在对急性冠状动脉综合征样症状的差异诊断中考虑压力诱导心肌病的重要性,特别是在绝经后的妇女中.
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