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Colegio de Medicina Interna de México.

2017, Número 3

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Med Int Mex 2017; 33 (3)


Cardiomiopatía de takotsubo secundaria a sepsis. Una asociación poco frecuente

Carrillo-Esper R, Rosado-Garduño P, Ramírez-Ambriz PM, Sánchez-Zúñiga MJ

Idioma: Español
Referencias bibliográficas: 75
Paginas: 427-435
Archivo PDF: 470.70 Kb.


RESUMEN

La cardiomiopatía de takotsubo se distingue por alteraciones en la contractilidad apical del ventrículo izquierdo, dolor torácico, alteraciones electrocardiográficas y elevación enzimática, que semejan un síndrome coronario agudo, pero sin que haya alteraciones significativas en las arterias coronarias. Es desencadenado por estrés emocional o físico, como el que ocurre en hemorragia subaracnoidea, lesión cerebral traumática y sepsis. El mecanismo fisiopatogénico está relacionado con liberación masiva de catecolaminas, lo que induce miocardiopatía aguda, que se incluye en el síndrome neurocardiogénico. Describimos el caso de una paciente de 80 años que padeció sepsis secundaria a un cuadro neumónico y que sufrió de manera súbita insuficiencia cardiaca, edema pulmonar, alteraciones del segmento ST y de la onda T y elevación de enzimas cardiacas. En el ecocardiograma se observó hipocinesia apical, con movilidad anterobasal normal. En el ventriculograma se corroboraron las alteraciones de movilidad. Las arterias coronarias eran normales. Los intensivistas deben tener en mente la relación entre sepsis y cardiomiopatía de takotsubo.


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