[Takotsubo cardiomyopathy associated with abnormal birth of the coronary arteries].

Jesús Guadalupe González-Jasso, Yuyi Lizeth Montero-Pola, Otoniel Toledo-Salinas, Werner Schlie-Villa, Alexander Muñóz-López, Ernesto García-Hernández
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Abstract

Background: Takotsubo cardiomyopathy (TM) is a form of non-ischemic cardiomyopathy. It is characterized by transient regional systolic dysfunction of the left ventricle that mimics acute myocardial infarction. The main objective of this article is to report the case of a patient with TM associated with abnormal birth of the left coronary trunk.

Clinical case: A 76-year-old woman with typical angina at rest, with an electrocardiogram that showed dynamic changes in the T wave and elevation of biomarkers. Coronary angiography showed epicardial coronary arteries without significant lesions and abnormal birth of the left coronary trunk from the proximal segment of the right coronary artery. The patient progressed favorably, and the transthoracic echocardiogram showed no mobility disorders 3 months after the event.

Conclusions: TM and abnormal birth of the coronary arteries are rare diseases whose simultaneous presentation is extraordinary. The diagnosis of both clinical entities is made by coronary angiography and echocardiogram, and their treatment is similar to that of patients with acute coronary syndrome. Abnormal birth of the left coronary trunk with retroaortic switch reaching the contralateral site has a good clinical prognosis and echocardiographic follow-up should be performed 4 weeks after the onset of the condition.

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[Takotsubo心肌病与冠状动脉异常出生有关]。
背景:Takotsubo心肌病(TM)是一种非缺血性心肌病。它的特征是左心室短暂的局部收缩功能障碍,类似于急性心肌梗死。本文的主要目的是报告一例与左冠状动脉干异常出生相关的TM患者。临床病例:76岁女性,静息时典型心绞痛,心电图显示T波动态变化和生物标志物升高。冠状动脉造影显示心外膜冠状动脉无明显病变,左冠状动脉干从右冠状动脉近段异常生成。患者进展良好,事件发生3个月后经胸超声心动图显示无活动障碍。结论:TM与冠状动脉异常出生是一种罕见的疾病,同时出现的情况非常罕见。两种临床实体的诊断都是通过冠状动脉造影和超声心动图进行的,其治疗方法与急性冠状动脉综合征患者相似。左冠状动脉干异常出生并主动脉后开关到达对侧部位,临床预后良好,应在发病后4周进行超声心动图随访。
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