Tako Tsubo Syndrome yog ib hom kab mob ntawm cov leeg nqaij uas ua rau lub plawv tsis ua haujlwm ntawm sab laug ventricle. Txij li thaum nws thawj qhov kev piav qhia hauv Nyij Pooj xyoo 1990, Tako Tsubo syndrome tau txais kev lees paub thoob ntiaj teb. Txawm li cas los xij, tom qab 30 xyoo ntawm kev siv zog ntau ntxiv kom nkag siab txog tus kab mob no, kev paub tam sim no tseem txwv.

Tako Tsubo Syndrome yog ib hom kab mob ntawm cov leeg nqaij uas ua rau lub plawv tsis ua haujlwm ntawm sab laug ventricle.

Qhov no cardiomyopathy siv nws lub npe los ntawm Japanese "octopus ntxiab", vim yog cov duab ntawm sab laug ventricle siv nyob rau hauv feem ntau: tsam plab nyob rau sab saum toj ntawm lub plawv thiab nqaim ntawm nws lub hauv paus. Takotsubo syndrome tseem hu ua "broken heart syndrome" thiab "apical ballooning syndrome".

Takotsubo syndrome suav txog li 1 txog 3% ntawm tag nrho cov neeg mob thoob ntiaj teb. Raws li cov ntaub ntawv, kwv yees li 90% ntawm cov neeg mob uas muaj tus mob no yog cov poj niam hnub nyoog ntawm 67 thiab 70 xyoo. Cov poj niam muaj hnub nyoog 55 xyoos muaj kev pheej hmoo ntau dua ntawm tus kab mob ntau dua li cov poj niam hnub nyoog qis dua 55 xyoos thiab muaj kev pheej hmoo siab dua li cov txiv neej.

Cov tsos mob feem ntau ntawm Tako Tsubo syndrome yog:

• Mob hauv siab;
• Dyspnea: nyuaj lossis ua tsis taus pa;
• Ib tug syncope: dheev tsis nco qab.

Kev kho mob tshwm sim ntawm Takotsubo syndrome tshwm sim los ntawm kev ntxhov siab ntawm lub cev hnyav tuaj yeem raug tswj hwm los ntawm qhov tshwm sim ntawm tus kab mob hauv qab. Hauv cov neeg mob uas muaj ischemic stroke lossis qaug dab peg, Takotsubo syndrome tsis tshua muaj nrog mob hauv siab. Nyob rau hauv sib piv, cov neeg mob uas muaj kev ntxhov siab nyob rau hauv lub siab lub ntsws muaj feem ntau ntawm cov mob hauv siab thiab palpitations.

Nws yog ib qho tseem ceeb uas yuav tsum nco ntsoov tias cov kab mob ntawm cov neeg mob Takotsubo tuaj yeem tshwm sim nrog cov tsos mob tshwm sim los ntawm nws cov teeb meem:

• Lub plawv tsis ua hauj lwm;
• Pulmonary edema;
• Kev puas tsuaj ntawm cerebral vascular;
• Cardiogenic poob siab: tsis ua hauj lwm ntawm lub plawv twj tso kua mis;
• Mob plawv;

Kev kuaj mob ntawm Takotsubo syndrome feem ntau nyuaj rau kev paub qhov txawv ntawm qhov mob myocardial infarction. Txawm li cas los xij, hauv qee tus neeg mob nws tuaj yeem kuaj pom qhov xwm txheej los ntawm kev hloov pauv hauv electrocardiogram (ECG) lossis nce sai sai hauv cov hlab plawv biomarkers - cov khoom tso tawm rau hauv cov ntshav thaum lub plawv puas.

Coronary angiography nrog rau sab laug ventriculography - zoo thiab ntau npaum li cas radiography ntawm sab laug ventricular muaj nuj nqi - yog suav hais tias yog lub kub txheej txheem kuaj cov cuab yeej los txiav txim los yog paub meej tias tus kab mob.

Ib qho cuab yeej, hu ua InterTAK cov qhab nia, kuj tuaj yeem qhia kev kuaj mob ntawm Takotsubo syndrome. Rated tawm ntawm 100 cov ntsiab lus, InterTAK cov qhab nia yog raws li xya yam: 

• Poj niam pw (25 ntsiab lus);
• Lub hav zoov ntawm kev puas siab puas ntsws (24 ntsiab lus);
• Lub hav zoov ntawm lub cev muaj zog (13 ntsiab lus);
• Tsis muaj kev nyuaj siab ntawm ST ntu ntawm electrocardiogram (12 ntsiab lus);
• Kev puas siab puas ntsws keeb kwm (11 ntsiab lus);
• Neurological keeb kwm (9 ntsiab lus);
• Kev ncua ntawm QT ntu ntawm electrocardiogram (6 ntsiab lus).

Qhov qhab nees siab dua 70 yog txuam nrog qhov tshwm sim ntawm tus kab mob sib npaug li 90%.

Feem ntau Takotsubo syndromes yog tshwm sim los ntawm cov xwm txheej ntxhov siab. Lub cev ua rau muaj ntau dua li kev ntxhov siab ntawm kev xav. Ntawm qhov tod tes, cov txiv neej cov neeg mob feem ntau cuam tshuam los ntawm kev ntxhov siab ntawm lub cev, thaum nyob rau hauv cov poj niam qhov kev xav tau tshwm sim ntau dua. Thaum kawg, cov xwm txheej kuj tshwm sim thaum tsis muaj kev ntxhov siab pom tseeb.

Lub cev ua rau

Ntawm cov txiaj ntsig ntawm lub cev yog:

• Kev ua ub no ntawm lub cev: kev ua vaj tse hnyav lossis kev ua si;
• Cov kev kho mob sib txawv los yog cov xwm txheej tsis sib xws: mob ua pa tsis ua haujlwm (asthma, theem kawg ntawm cov kab mob pulmonary chronic obstructive pulmonary), pancreatitis, cholecystitis (mob ntawm lub gallbladder), pneumothorax, traumatic raug mob, sepsis, kws khomob, xov tooj cua, cev xeeb tub, phais phais, xob laim, nyob ze-drowning, hypothermia, cocaine, cawv los yog tshem tawm opioid, carbon monoxide lom, thiab lwm yam.
• Qee cov tshuaj, suav nrog kev kuaj dobutamine, kuaj electrophysiological (isoproterenol lossis epinephrine), thiab beta-agonists rau mob hawb pob lossis mob ntsws ntsws;
• Mob obstruction ntawm coronary hlab ntsha;
• Kev cuam tshuam ntawm lub paj hlwb: mob stroke, taub hau raug mob, intracerebral hemorrhage lossis convulsions;

Psychological triggers

Ntawm cov kev puas siab puas ntsws yog:

• Kev tu siab: kev tuag ntawm ib tug neeg hauv tsev neeg, phooj ywg lossis tus tsiaj;
• Kev tsis sib haum xeeb ntawm tus kheej: kev sib nrauj lossis tsev neeg sib cais;
• Ntshai thiab ntshai: tub sab nyiag, ntaus lossis hais lus rau pej xeem;
• Npau taws: kev sib cav nrog tsev neeg lossis tus tswv tsev;
• Kev ntxhov siab: kev mob ntawm tus kheej, kev zov me nyuam lossis tsis muaj tsev nyob;
• Cov teeb meem nyiaj txiag lossis kev tshaj lij: kev twv txiaj poob, kev lag luam poob lossis poob haujlwm;
• Lwm yam: kev foob, kev tsis ncaj ncees, raug kaw hauv tsev neeg, poob hauv kev cai lij choj, thiab lwm yam.;
• Kev puas tsuaj ntuj xws li av qeeg thiab dej nyab.

Thaum kawg, nws yuav tsum tau muab sau tseg tias qhov kev xav ntawm tus kab mob no tsis yog ib txwm tsis zoo: cov xwm txheej zoo siab kuj tuaj yeem ua rau tus kab mob: lub hnub yug surprise, qhov tseeb ntawm kev yeej jackpot thiab kev xam phaj ua haujlwm zoo, thiab lwm yam. Lub koom haum no tau ua. piav raws li "zoo siab lub plawv syndrome".

Tom qab thawj kis ntawm Takotsubo syndrome, cov neeg mob muaj kev pheej hmoo ntawm kev rov tshwm sim, txawm tias xyoo tom qab. Qee yam tshuaj zoo li qhia tau tias muaj kev txhim kho hauv kev muaj sia nyob ntawm ib xyoos thiab qhov txo qis ntawm qhov rov tshwm sim:

• ACE inhibitors: lawv inhibits kev hloov pauv ntawm angiotensin I mus rau angiotensin II - ib qho enzyme uas ua rau cov hlab ntsha txhaws - thiab nce qib ntawm bradykinin, ib qho enzyme nrog vasodilating teebmeem;
• Angiotensin II receptor antagonists (ARA II): lawv thaiv qhov kev txiav txim ntawm eponymous enzyme.
• Ib qho tshuaj antiplatelet (APA) yuav raug txiav txim siab raws li rooj plaub tom qab mus pw hauv tsev kho mob thaum muaj mob sab laug ventricular hnyav cuam tshuam nrog kev pheej hmoo ntawm apical bloating.

Lub luag haujlwm muaj peev xwm ntawm ntau tshaj catecholamines - cov organic tebchaw tsim los ntawm tyrosine thiab ua raws li cov tshuaj hormones lossis neurotransmitter, feem ntau yog adrenaline, norepinephrine thiab dopamine - hauv kev txhim kho ntawm Takotsubo cardiomyopathy tau sib cav rau lub sijhawm ntev, thiab xws li, beta-blockers tau raug npaj los ua ib txoj kev kho mob. Txawm li cas los xij, lawv zoo li tsis muaj txiaj ntsig zoo nyob rau lub sijhawm ntev: qhov rov tshwm sim ntawm 30% yog pom hauv cov neeg mob kho nrog beta-blockers.

Lwm txoj hauv kev kho mob tseem yuav tau tshawb nrhiav, xws li tshuaj tiv thaiv coagulants, kev kho hormonal rau menopause lossis kev kho mob hlwb.

Cov yam tseem ceeb rau Takotsubo syndrome tuaj yeem muab faib ua peb hom:

• Hormonal yam tseem ceeb: lub striking preponderance ntawm postmenopausal cov poj niam qhia ib tug hormonal cawv. Cov tshuaj estrogen qis dua tom qab lub cev tsis muaj zog muaj peev xwm ua rau cov poj niam muaj kev cuam tshuam rau Takotsubo syndrome, tab sis cov ntaub ntawv qhia tau hais tias qhov kev sib txuas meej ntawm ob yog tsis muaj tam sim no;
• Cov yam ntxwv ntawm caj ces: nws muaj peev xwm hais tias cov caj ces muaj peev xwm cuam tshuam nrog ib puag ncig yam cuam tshuam rau qhov pib ntawm tus kab mob, tab sis ntawm no ib yam nkaus, kev tshawb fawb tso cai rau qhov kev lees paub dav dav yog tsis muaj;
• Psychiatric thiab Neurological Disorders: Feem ntau ntawm kev puas siab puas ntsws - ntxhov siab, kev nyuaj siab, inhibition - thiab neurological ntshawv siab tau raug tshaj tawm nyob rau hauv cov neeg mob nrog Takotsubo syndrome.