Takotsubo cardiomyopathy following envenomation:An updated review  

作　　者：Ajay K Mishra Anu A George Kevin John John Pramukh Arun Kumar Mahati Dasari Mohammed Afraz Pasha Michelle Hadley 

机构地区：[1]Division of Cardiology,Saint Vincent Hospital,Worcester,MA 01608,United States [2]Department of Medicine,Saint Vincent Hospital,Worcester,MA 01608,United States [3]Department of Medicine,Tufts Medical Center,Boston,MA 02111,United States [4]Department of Medicine,North Alabama Medical Center,Florence,AL 35630,United States

出　　处：《World Journal of Cardiology》2023年第1期33-44,共12页世界心脏病学杂志（英文版）（电子版）

摘　　要：BACKGROUND Takotsubo cardiomyopathy(TTC)can be diagnosed in patients presenting with clinical features of acute coronary syndrome(ACS)by using Mayo clinic criteria.Multiple precipitators have been attributed to causing TTC.Rarely it has been reported to occur following an acute envenomation.AIM This review describes the various patterns,mechanisms,and outcomes of envenomation induced TTC.METHODS In this review,we included all studies on“TTC”and“envenomation”published in the various databases before June 2022.To be included in the review articles had to have a distinct diagnosis of TTC and an envenomation RESULTS A total of 20 patients with envenomation induced TTC were identified.Most episodes of envenomation induced TTC were reported following a bee sting,scorpion sting,and snake envenomation.Fear and anxiety related to the sting,direct catecholamine toxicity and administration of exogenous beta-adrenergic agents have been commonly postulated to precipitate TTC in these patients.95%of these patients presented with a clinical picture of ACS.Most of these patients also fulfill at least 3 out of 4 criteria of Mayo clinic criteria for TTC.Echocardiographic evidence of Apical TTC was noted in 72%of patients.94%of these patients had clinical improvement following optimal management and 35%of these patients were treated with guideline directed medications for heart failure.CONCLUSION Envenomation following multiple insect stings and reptile bites can precipitate TTC.Most reported envenomation related TTC has been due to bee stings and scorpion bites.Common mechanisms causing TTC were fear,anxiety,and stress of envenomation.Most of these patients present with clinical presentation of ACS,ST elevation,and elevated troponin.The most common type of TTC in these patients is Apical,which improved following medical management.

关 键 词：Takotsubo cardiomyopathy ENVENOMATION MECHANISM OUTCOME 

分 类 号：R542.2[医药卫生—心血管疾病]