应激性心肌病诊治进展

Advancements in Diagnosis and Management of Stress Cardiomyopathy

应激性心肌病系强烈精神刺激或躯体应激引发的以一过性左心室功能不全为特点的一组心脏综合征。左心室节段性活动异常(左心室心尖部运动减弱或消失)但不伴有冠状动脉器质性狭窄为本病典型表现。急性期应根据患者血流动力学状况,实施个体化治疗,对血流动力学不稳定患者应及早给予主动脉内球囊反搏。稳定期则应联合使用α及β受体阻滞剂,以预防交感神经过度激活。通常本病预后颇佳,甚少复发。

Stress cardiomyopathy is a cardiac syndrome characterized by transient left ventricular dysfunction following acute emotional or physical stress. Typical findings are disturbances of segmental left ventricles contractility （ apical hypokinesia or akinesia） with normal epicardial coronary arteries. In the acute phase, therapy must be individualized depending on a patient＇s hemodynamic status. In stable con- ditions, it appears advantageous to prevent excessive sympathetic activation by combining alpha and beta blockers. In hemodynamically un- stable patients, early administration of intra-aortic balloon pump counterpulsation should be considered. The prognosis is generally favorable and recurrence is very rare.