应激性心肌病诊疗一例

A Case Report of Stress Cardiomyopathy

摘要: 应激性心肌病(stress cardiomyopathy, SCM)常诱发于剧烈情绪或生理应激，以左心室收缩或舒张功能暂时异常及室壁运动异常为特征。该病的发病机制目前尚未明确。1997年，Pavin等研究发现SCM可能由强烈情绪应激后的过量儿茶酚胺所诱发。目前认为交感神经兴奋及儿茶酚胺的直接刺激心肌作用可能是SCM的主要发病机制。本文通过讨论此病例及其治疗，提示SCM患者除外强烈情绪应激外，仍要注意其他病因，减少误诊，尽早明确诊断，对症治疗，改善患者预后。

Abstract: Stress cardiomyopathy (SCM) is often induced by intense emotional or physiological stress and is characterized by temporary abnormalities in systolic or diastolic function of the left ventricle and abnormal wall movement. The pathogenesis of the disease is not well understood. In 1997, Pavin et al. found that SCM may be induced by excessive catecholamines after intense emotional stress. At present, it is believed that sympathetic nerve excitation and the direct myocardial stimulation of catecholamines may be the main pathogenesis of SCM. By discussing this case and its treatment, it is suggested that in addition to strong emotional stress, SCM patients should pay attention to other causes, reduce misdiagnosis, make clear diagnosis as soon as possible, and treat the symptoms to improve the prognosis of patients.