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心碎综合征 |
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Takotsubo cardiomyopathy, also known as stress cardiomyopathy, is a type of non-ischemic cardiomyopathy in which there is a sudden temporary weakening of the muscular portion of the heart. This weakening may be triggered by emotional stress, such as the death of a loved one, a break-up, rejection from a partner or constant anxiety.
Tokotsubo心肌病，也被称为应激性心肌病，是一种非缺血性心肌病，心脏肌肉部分突然暂时减弱。这种减弱可能是由情绪压力引起的，如爱人的死亡、分手、伴侣的排斥或持续的焦虑。
This leads to one of the common names, broken heart syndrome. Stress cardiomyopathy is now a well-recognized cause ofacute heart failure, lethal ventricular arrhythmias, and ventricular rupture. The name "takotsubo syndrome" comes from the Japanese word takotsubo "octopus trap," because the left ventricle takes on a shape resembling a fishing pot.
这就引出了一个常见的名字-心碎综合症。应激性心肌病现在是引起急性心力衰竭、致命性室性心律失常和心室破裂的一个公认原因。“takotsubo综合征”一词来源于日语中的takotsubo“章鱼陷阱”，“因为左心室呈钓鱼壶状。”
1.History
Although the first scientific deion of takotsubo cardiomyopathy was not until the 1990s, Cebelin and Hirsch wrote about human stress cardiomyopathy in 1980. The two looked at homicidal assaults that had happened in Cuyahoga County, Ohiothe past 30 years, specifically those with autopsies who had no internal injury, but had died of physical assault.
虽然直到20世纪90年代，Tokotsubo心肌病才第一次被科学描述，在1980年Cebelin和Hirsch就写过关于人类应激性心肌病的文章。这两人调查了过去30年在俄亥俄州库亚霍加县发生的凶杀案，特别是那些尸检没有内伤但死于人身攻击的人。
They found that 11 of 15 had myofibrillar degeneration similar to animal stress studies. In the end, they concluded their data supported "the theory of catecholamine mediation of these myocardial changes in man and of the lethal potential of stress through its effect on the heart".
他们发现，15人中有11人有类似动物应激研究的肌原纤维变性。他们的数据支持了“儿茶酚胺通过其对心脏的影响来调节人类心肌变化和应激致死潜力的理论”。
The first studied case of takotsubo cardiomyopathy was in Japan in 1991 by Sato et al. More cases of the syndrome appeared in Japan within the next decade. The Japanese at last reported about the syndrome to the west in 2001 under the name "transient LV apicawww.58yuanyou.coml ballooning" . The syndrome reached international audiences through the media in 2005 when the New England Journal of Me原由网dicine wrote about the syndrome.
1991年，佐藤等人在日本发现了第一个被研究的Tokotsubo心肌病病例。在接下来的十年里，日本出现了更多的这种综合症病例。2001年，日本人以“短暂的左室心尖膨胀”的名称向西方报告了这种综合症。2005年，“新英格兰医学杂志”(NewEngland Journal Of Medicine)报道了这种综合症。
2. Signs and symptoms
The typical presentation of takotsubo cardiomyopathy is chest pain associated with ECG changes mimicking a myocardial infarction of the anterior wall. During the course of evaluation of the patient, a bulging out of the left ventricular apex with a hypercontractile base of the left ventricle is often noted. It is the hallmark bulging-out of the apex of the heart with preserved function of the base that earned the syndrome its name takotsubo "octopus trap".
典型的表现是胸痛、心电图的变化类似于前壁心肌梗死。在对病人进行评估的过程中，经常会发现左心室尖隆起并伴有左心室高度收缩。正是心脏尖部凸出的特征，才把这种综合症命名为“章鱼陷阱”(takotsubo“octopus诱捕器”)。
Stress is the main factor in takotsubo cardiomyopathy, with more than 85% of cases set in motion by either a physically or emotionally stressful event that prefaces the start of symptoms.
压力是导致Tokotsubo心肌病的主要因素，超过85%的病例都是由身体或情绪紧张的事件引发的，这些事件会导致症状的开始。
Examples of emotional stressors include grief from the death of a loved one, fear of public speaking, arguing with a spouse, relationship dis//www.58yuanyou.comagreements, betrayal, and financial problems. Acute asthma, surgery, chemotherapy, and stroke are examples of physical stressors.Iwww.58yuanyou.comn a few cases, the stress may be a happy event, such as a wedding, winning a jackpot, a sporting triumph, or a birthday.
情绪压力的例子包括因爱人去世而产生的悲伤、害怕公开演讲、与配偶争吵、关系分歧、背叛和经济问题。急性哮喘，外科手术，化疗，中风是身体压力的例子。在一些情况下，压力可能是一个愉快的事件，如婚礼，中奖，体育胜利，或生日。
Takotsubo cardiomyopathy is more commonly seen in postmenopausal women. Often there is a history of a recent severe (usually negative, sometimes happy) emotional or physical stress.
Tokotsubo心肌病在绝经后妇女中更常见。经常有最近严重的(通OOGnOkOzOZ常是负面的，有时是快乐的)情绪或身体压力的病史。
3.Prognosis
Despite the grave initial presentation in some of the patients, most of the patients survive the initial acute event, with a very low rate of in-hospital mortality or complications.
尽管在一些病人始发症状很严重，但是大多数病人能够在最初的急性事件中存活下来，住院死亡率和并发症的比率非常低。
Once a patient has recovered from the acute stage of the syndrome, they can expect a favorable outcome and the long-term prognosis is excellent.Even when ventricular systolic function is heavily compromised at presentation, it typically improves within the first few days and normalises within the first few months.
一旦病人从综合症的急性期恢复过来，他们就可以获得良好的预后，长期的预后也是很好的。即使在出现心室收缩功能严重受损的情况下，它通常在前几天内好转，并且在几个月内恢复正常。
4.Epidemiology
Takotsubo cardiomyopathy is rare, affecting between 1.2% and 2.2% of people in Japan and 2% to 3% in western countries . It also affects far more women than men with 90% of cases being women, most postmenopausal.
Takotsubo心肌病是罕见的，在日本的发病率为1.2%到2.2%，西方国家为2%到3%。女性比男性更容易受到影响，90%的病例是女性，大多数是绝经后妇女。
Scientists believe one reason is that estrogen causes the release ofcatecholamine and glucocorticoid in response to mental stress. The average ages at onset are between 58 and 75 years. Less than 3% of cases occurred in patients under age 50.
科学家认为一个原因是雌激素会导致儿茶酚胺和糖皮质激素在精神压力下的释放。发病时的平均年龄在58岁到75岁之间。只有不到3%的病例发生在50岁以下的患者。
文章来源：维基百科
Medical English Learning
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