'Broken heart syndrome' : Takotsubo cardiomyopathy
Sindrom 'slomljenog srca' - takotsubo kardiomiopatija
CASE REPORT SESTRINSKA REČ PRIKAZ SLUČAJA 34 UVOD P sihosomatska bolest je telesna bolest, sa pato-anatomskim oštećenjima, nastala delovanjem nekoliko etioloških faktora, među kojima psihogenom pripada prioritetno mesto. Osnovni uzrok je stres. Dugodecenijska istraživanja se mogu svesti na sledeće: stres je uniformni ali nespecifični odgovor organizma na delovanje stresora; stresor je svaki agens koji može da ugrozi telesni i pihički integritet individue; postoji samo mali broj univerzalnih
... oj univerzalnih stresora (bolest, rat, zemljotres). Odgovor organizma se odvija kroz tri faze: faza alarma (brza reakcija) organizma po adrenergičnoj osi; faza otpora koja se odvija uglavnom preko parasimpatikusa i faza iscrpljenja . ABSTRACT INTRODUCTION: Psychosomatic diseases indicate a causal relationship between mental and somatic illnesses in clinical practice. A broken heart syndrome or Takotsubo cardiomyopathy is of a recent date and was first described in 1991 by Japanese doctors. The syndrome is 9 times more common in women, and it is characteristic that over 60% of patients experience severe emotional stress before the onset of symptoms. This condition mimics the symptoms of a heart attack, and often in such a state, the wrong diagnosis is made to the patient. CASE REPORT: The patient was not previously treated as a cardiac and psychiatric patient. Seven days before the onset of acute cardiac problems, the stressful situation was preceded by the death of the patient's wife. He was received as an emergency case in the coronary unit of the Internal Department of the General Hospital Šabac, and the following day, due to a clinical finding, was sent to the General Hospital in Valjevo for emergency coronarography. Conclusion of the findings of coronarography: on coronary arteries, angiographically, no significant stenoses are observed. Further internist and psychiatric medication therapy was proposed at the competent hospital. CONCLUSION: Our goal was to point out the necessity of a holistic approach to each patient by each physician, because the only adequate treatment in psychosomatic patients is the simultaneous treatment of somatic illness and the use of psychopharmaceuticals. Acute stress due to emotional loss, with further present anxiety, has caused acute cardiac problems, which will further be prevented by regular psychiatric treatment. KEY WORDS: "broken heart syndrome" or takotsubo cardiomyopathy, acute stress, psychosomatics, women.