Cinsel saldırı sonrası bir oktogenarda gelişen takotsubo kardiyomiyopatisi

Öz

Takotsubo kardiyomiyopatisi TTC , koroner anjiyografide kritik koroner arter hastalığı olmadan sol ventrikül disfonksiyonu ve miyokard enfarktüsü bulgularının olduğu akut koroner sendrom gibi kardiyovasküler sendromdur. Bu hastalık genellikle duygusal stres, fiziksel ve ekonomik olaylardan sonra yaşlı ve postmenopozal kadınlarda görülür. Hastalar akut koroner sendromun çeşitli varyantları ile acil servise başvurur. Bu yazıda, cinsel istismar ve saldırıdan sonra dispne, göğüs ağrısı ve vücut travması ile acil servise başvuran 87 yaşında bir kadın olguyu tanımladık.Dolayısıyla bu vaka aynı zamanda adli ve psikiyatrik br olgudur. Kardiyak kateterzasyonda koroner arterlerde kritik darlık gözlenmedi ve sol ventrikülde apikal balonlaşma gözlendi. TTC, birkaç gün içinde klinik ve laboratuvar değerlerinin iyileşmesi ile karakterizedir.

Anahtar Kelimeler

• Takotsubo kardiyomiyopatisi
• Cinsel travma
• Apikal balonlaşma
• Oktogenar

Takotsubo cardiomyopathy after sexual abuse in an octogenarian

Öz

Takotsubo cardiomyopathy TTC is a cardiovascular syndrome similar to acute coronary syndrome presenting with left ventricular dysfunction and myocardial infarction without critical coronary artery disease in coronary angiography. This disease is usually seen in elderly and postmenopausal women after emotional stress or physical or economic crises. Patients present to the emergency room with variants of acute coronary syndrome. In this article, we describe the case of an 87-year-old woman who applied to the emergency department with dyspnea, chest pain, and body trauma after sexual abuse and assault, so this case is also a forensic case. There was no critical stenosis in the cardiac catheterization and apical ballooning was observed in the left ventricle. TTC is characterized by improvement of clinical and laboratory values in a few days.

Anahtar Kelimeler

• Takotsubo cardiomyopathy
• Sexual trauma
• Apical ballooning
• Octogenarian

Kaynakça

1. Akashi YJ, Nakazawa K, Sakakibara M, Miyake F, Koike H, Sasaka K. The clinical features of takotsubo cardiomyopathy. QJM 2003;96 8 :563-73.
2. Veillet-Chowdhury M, Hassan SF, Stergiopoulos K. Ta- kotsubo cardiomyopathy: A review. Acute Card Care ;16 1 :15-22.
3. Abraham J, Mudd JO, Kapur. Stress cardiomyopathy after intravenous administration of catecholamines and beta-re- ceptor agonists. J Am Coll Cardiol 2009; 53: 1320-5.
4. Sharkey SW, Lesser JR, Zenovich AG et al: Acute and re- versible cardiomyopathy provoked by stress in women from the United States. Circulation 2005;111:472–9.
5. Gianni M, Dentali F, Grandi AM, Sumner G, Hiralal R, Lonn E. Apical ballooning syndrome or takotsubo cardiomyopathy: a systematic review. Eur Heart J 2006;27 13 :1523-9
6. Prasad A, Lerman A, Rihal CS: Apical ballooning syndrome Tako-Tsubo or stress cardiomyopathy : A mimic of acute myocardial infarction. Am Heart J 2008;155:408–17.
7. Madhavan M , Borlaug BA , Lerman A , Rihal CS , Prasad A. Stress hormone and circulating biomarker profile of apical ballooning syndrome Takotsubo car- diomyopathy : insights into the clinical significance of B-type natriuretic pep- tide and troponin levels. Heart 2009;95 17 :1436–41 .
8. Saffari M, Lin CY, Broström A, Mårtensson J, Malm D, Burri A, Fridlund B, Pakpour AH. Investigating sexual problems, psychological distress and quality of life in female patients with Takotsubo cardiomyopathy. Eur J Cardiovasc Nurs 2017 Oct;16 7 :614-22.

9. Hansen PR. Takotsubo cardiomyopathy: an under-recog- nized myocardial syndrome. Eur J Intern Med 2007;18 8 :561-5.
10. Elesber AA, Prasad A, Lennon RJ. Four-year recurrence rate and prognosis of the apical ballooning syndrome. J Am Coll Cardiol 2007;50:448-52.