Author/Editor		Lobnik, Anton; Šuran, David; Sinkovič, Andreja
Title		Sindrom Tako-tsubo pri bolnikih, zdravljenih v Splošni bolnišnici Maribor v letih 2004-2006
Translated title		Syndrome Tako-tsubo in patients treated in General Hospital Maribor in 2004-2006
Type		članek
Source		Slov Kardiol
Vol. and No.		Letnik 3, št. 1
Publication year		2007
Volume		str. 22-6
Language		slo
Abstract		Background. Tako-Tsubo syndrome refers to transient stunning with the abnormalities of the left ventricle-hyperkinetic narrow apex and akinetic mid-ventricular segment, manifesting itself clinically as chest pain, changes in ECG and an increase of a troponin. Heart failure, cardiac rupture with tamponade and even death are considered as possible complications. Significant occlusions of coronary arteries are excluded, ventriculography, however, demonstrates the typical abnormalities of the left ventricle. Our aim is to present Tako-Tsubo syndrome patients, treated at the General Hospital Maribor. Methods. From 2004 to 2006 14 women with the average age of 61.2 +/- 14.8 years were admitted due to the suspicion of acute coronary syndrome (ACS) with or without ST-segment elevation on ECG. Troponin T levels were estimated by immuno method (normal levels up to 0,1 [micro]g/l), emergency coronary angiography and ventriculography were performed and later echocardiography. Results. 71.4 % of our patients were >55 years old, 71.4 % with previously treated arterial hypertension, 28.6 % with dislipidemia, 25 % were smokers, all previously exposed to physical and emotional stress, 14.3 % with ST-segment elevation, 35.7 % with ST-segment depression and 41.3 % with a negative T-wave on ECG and average admission troponin T 0.45 +/- 0.38 [micro]g/l. Significant coronary occlusions were excluded by coronary arteriography and ventriculography demonstrated the characteristic abnormalities of the left ventricle. During treatment, we observed arrhythmias in 14.2 % of patients, heart failure of Killip class II in 28.6 %, in 7.1 % ventricular fibrillation and pulmonary oedema with cardiogenic shock and subsequent lethal outcome. in 7.1 % of patients. Conclusion. Tako-Tsubo syndrome mostly occurs as ACS without ST-segment ele
Summary		Izhodišča. Sindrom Tako-tsubo pomeni prehodno otrplost ("stunning") srčne mišice s preoblikovanjem levega prekata - hiperkineti en ozek vrat ter akineti na osrednji del in konica. Ob tem so prisotne bolečine v prsih, spremembe v EKG in povišanje troponina. Možni zapleti so srčno popuščanje, ruptura srca s tamponado in smrt. Koronarografija izključi pomembne zožitve na venčnih arterijah, ventrikulografija pa prikaže značilno preoblikovan levi prekat. Naš cilj je prikaz bolnikov s sindromom Tako-tsubo, zdravljenih v Splošni bolnišnici Maribor. Metode. Od 2004 do 2006 smo sprejeli 14 bolnic, povprečno starih 61,2 +/- 14,8 let zaradi suma na akutni koronarni sindrom z dvigom veznice ST ali brez njega v EKG. Določili smo jim vrednosti troponina T (imunska metoda, normalne vrednosti do 0,1 [mikro]g/l), opravili koronarografijo in ventrikulografijo ter kasneje ultrazvok srca. Rezultati. 71,4 % vseh bolnic je bilo starejših od 55 let, 71,4 % jih je predhodno imelo arterijsko hipertenzijo, 28,6 % dislipidemijo, 25 % je bilo kadilk, vse so navajale duševni ali telesni stresni dogodek. 14,3 % jih je imelo dvignjeno veznico ST, 35,7 % znižano veznico ST in 41,3 % negativni val T v EKG. Povpre ni troponin T ob sprejemu je bil 0,45 +/- 0,38 [mikro]g/l. Koronarografija je izključila pomembne zožitve venčnih arterij, ventrikulografija dokazala značilno prehodno preoblikovanje levega prekata. Med zdravljenjem smo opazovali aritmije pri 14,2 %, srčno popuščanje Killip 2 pri 28,6 %, v 7,1 % prekatno fibrilacijo in pri 7,1 % pljučni edem s kardiogenim šokom in smrtnim izidom. Zaključek. Sindrom Tako-tsubo se javlja največkrat kot AKS brez dviga veznice ST s porastom troponina T pri starejših bolnicah. Prognoza je ve inoma odli na, pri posameznikih so mo ne prekatna fibrilacija, ruptura srca s tamponado in smrtnim izidom, kar kaže na resnost opisanega kliničnega sindroma.
Descriptors		MYOCARDIAL STUNNING INTENSIVE CARE UNITS ELECTROCARDIOGRAPHY CORONARY ANGIOGRAPHY TROPONIN