Published online Mar 16, 2022. doi: 10.12998/wjcc.v10.i8.2616
Peer-review started: October 11, 2021
First decision: November 11, 2021
Revised: December 15, 2021
Accepted: January 5, 2022
Article in press: January 5, 2022
Published online: March 16, 2022
With the spread and establishment of the Chest Pain Center in China, adhering to the idea that “time is myocardial cell and time is life”, many hospitals have set up a standardized process that ensures that patients with acute myocardial infarction (AMI) who meet emergency percutaneous coronary intervention (PCI) guidelines are sent directly to the DSA room by the prehospital emergency doctor, saving the time spent on queuing, registration, payment, re-examination by the emergency doctor, and obtaining consent for surgery after arriving at the hospital. Takotsubo cardiomyopathy is an acute disease that is triggered by intense emotional or physical stress and must be promptly differentiated from AMI for its appropriate management.
A 52-year-old female patient was taken directly to the catheterization room to perform PCI due to 4 h of continuous thoracalgia and elevation of the ST segment in the V3–V5 lead, without being transferred to the emergency department according to the Chest Pain Center model. Loading doses of aspirin, clopidogrel and statins were administered and informed consent for PCI was signed in the ambulance. On first look, the patient looked nervous in the DSA room. Coronary angiography showed no obvious stenosis. Left ventricular angiography showed that the contraction of the left ventricular apex was weakened, and the systolic period was ballooning out, showing a typical “octopus trap” change. The patient was diagnosed with Takotsubo cardiomyopathy. Five days later, the patient had no symptoms of thoracalgia, and the serological indicators returned to normal. She was discharged with a prescription of medication.
Under the Chest Pain Center model for the treatment of patients with chest pain showing ST segment elevation, despite the urgency of time, Takotsubo cardiomyopathy must be promptly differentiated from AMI for its appropriate management.
Core tip: Under the Chest Pain Center model for the treatment of patients with chest pain with ST segment elevation, despite the urgency of time, Takotsubo cardiomyopathy must be promptly differentiated from myocardial infarction for its appropriate management.