I-Tako Tsubo syndrome yisifo semisipha yenhliziyo esibonakala ngokungasebenzi kwesikhashana kwe-ventricle yesokunxele. Kusukela yachazwa okokuqala eJapan ngo-1990, i-Tako Tsubo syndrome iye yaqashelwa emhlabeni wonke. Nokho, ngemva kweminyaka engu-30 yomzamo omkhulu wokuqonda lesi sifo kangcono, ulwazi lwamanje luhlala lulinganiselwe.

I-Tako Tsubo syndrome yisifo semisipha yenhliziyo esibonakala ngokungasebenzi kwesikhashana kwe-ventricle yesokunxele.

Le cardiomyopathy ithatha igama layo isuka ku "octopus gibe" waseJapan, ngenxa yesimo i-ventricle yangakwesobunxele esithathayo ezimeni eziningi: ukuqunjelwa phezulu kwenhliziyo nokuncipha esisekelweni sayo. I-Takotsubo syndrome yaziwa nangokuthi "isifo senhliziyo esiphukile" kanye "ne-apical ballooning syndrome".

I-Takotsubo syndrome ilandisa cishe nge-1 kuya ku-3% yazo zonke iziguli emhlabeni jikelele. Ngokusho kwezincwadi, cishe i-90% yeziguli ezine-syndrome ngabesifazane abaneminyaka ephakathi kwe-67 ne-70 iminyaka. Abesifazane abangaphezu kweminyaka engama-55 basengozini ephindwe kahlanu yokuhlaselwa yilesi sifo kunabesifazane abangaphansi kweminyaka engama-55 kanye nengcuphe ephakeme ngokuphindwe kayishumi kunabesilisa.

Izimpawu ezivame kakhulu ze-Tako Tsubo syndrome yilezi:

• Ubuhlungu besifuba esibukhali;
• I-Dyspnea: ubunzima noma ubunzima bokuphefumula;
• I-syncope: ukulahlekelwa ukwazi ngokuzumayo.

Ukubonakaliswa komtholampilo kwe-Takotsubo syndrome okubangelwa ukucindezeleka okukhulu ngokomzimba kungase kubuswe ukubonakaliswa kwesifo esibucayi esiyisisekelo. Ezigulini ezine-ischemic stroke noma ukuquleka, i-Takotsubo syndrome ayivamisile ukuhambisana nobuhlungu besifuba. Ngokuphambene nalokho, iziguli ezinezingcindezi ezingokomzwelo zivame ukwanda kobuhlungu besifuba kanye nokushaya kwenhliziyo.

Kubalulekile ukuqaphela ukuthi isethi engaphansi yeziguli ezine-Takotsubo syndrome ingaba nezimpawu ezivela ngenxa yezinkinga zayo:

• Ukuhluleka kwenhliziyo;
• I-edema yamaphaphu;
• Ingozi yemithambo yegazi yobuchopho;
• Ukushaqeka kwe-Cardiogenic: ukwehluleka kwepompo yenhliziyo;
• Ukuboshwa kwenhliziyo;

Ukuxilongwa kwe-Takotsubo syndrome kuvame ukuba nzima ukuhlukanisa ku-acute myocardial infarction. Kodwa-ke, kwezinye iziguli kungatholakala ngengozi ngokushintsha kwe-electrocardiogram (ECG) noma ukukhuphuka okungazelelwe kwezimpawu zenhliziyo - imikhiqizo ekhishelwa egazini lapho inhliziyo ilimele.

I-coronary angiography ene-left ventriculography - i-radiography yekhwalithi kanye nenani le-left ventricular function - ibhekwa njengethuluzi legolide elijwayelekile lokuxilonga ukuze kukhishwe noma kuqinisekiswe isifo.

Ithuluzi, elibizwa nge-InterTAK score, lingaphinda liqondise ngokushesha ukuxilongwa kwe-Takotsubo syndrome. Ilinganiselwe kumaphoyinti angu-100, isikolo se-InterTAK sisekelwe kumapharamitha ayisikhombisa: 

• Ubulili besifazane (amaphuzu angu-25);
• Ukuba khona kwengcindezi yengqondo (amaphuzu angama-24);
• Ukuba khona kokucindezeleka ngokomzimba (amaphuzu angu-13);
• Ukungabikho kokucindezeleka kwesigaba se-ST ku-electrocardiogram (amaphuzu angu-12);
• Umlando wezifo zengqondo (amaphuzu angu-11);
• umlando wezinzwa (9 amaphuzu);
• Ukwelulwa kwesikhawu se-QT ku-electrocardiogram (amaphuzu angu-6).

Amaphuzu angaphezu kuka-70 ahlotshaniswa namathuba okuba nesifo alingane nama-90%.

Iningi le-Takotsubo syndromes libangelwa izehlakalo ezicindezelayo. Izimbangela ezingokomzimba zivame kakhulu kunokucindezeleka ngokomzwelo. Ngakolunye uhlangothi, iziguli zabesilisa zivame ukuthinteka kakhulu yisenzakalo esicindezelayo esingokomzimba, kuyilapho kwabesifazane inhlamvu engokomzwelo ibonakala kaningi. Okokugcina, amacala abuye avele lapho kungekho ukucindezeleka okusobala.

Izimbangela zomzimba

Phakathi kwezimbangela zomzimba kukhona:

• Imisebenzi engokwenyama: ingadi ejulile noma ezemidlalo;
• Izimo ezihlukene zezokwelapha noma izimo zengozi: ukwehluleka kokuphefumula okunamandla (isifuba somoya, isifo sofuba esingamahlalakhona), i-pancreatitis, i-cholecystitis (ukuvuvukala kwenyongo), i-pneumothorax, ukulimala okubuhlungu, i-sepsis, ukwelashwa ngamakhemikhali, i-radiotherapy, ukukhulelwa, ukuhlinzwa, umbani, eduze nokuminza, i-hypothermia, i-cocaine, ukuhoxa utshwala noma i-opioid, ubuthi be-carbon monoxide, njll.
• Imithi ethile, kuhlanganise nokuhlolwa kokucindezeleka kwe-dobutamine, ukuhlolwa kwe-electrophysiological (isoproterenol noma i-epinephrine), kanye ne-beta-agonists yesifuba somoya noma isifo se-chronic obstructive pulmonary;
• Ukuvinjwa okunamandla kwemithambo ye-coronary;
• Imizwa yesimiso sezinzwa: ukushaywa unhlangothi, ukuhlukumezeka kwekhanda, ukopha kwe-intracerebral noma ukudlikizela;

Izimbangela zengqondo

Phakathi kwezimbangela ezingokwengqondo kukhona:

• Usizi: ukushona kwelungu lomndeni, umngane noma isilwane esifuywayo;
• Izingxabano phakathi kwabantu: isehlukaniso noma ukwehlukana komndeni;
• Ukwesaba nokwethuka: ukweba, ukushaya noma ukukhuluma esidlangalaleni;
• Intukuthelo: ingxabano nelungu lomndeni noma umnikazi wendawo;
• Ukukhathazeka: ukugula komuntu siqu, ukunakekelwa kwezingane noma ukungabi nakhaya;
• Izinkinga zezimali noma zomsebenzi: ukulahlekelwa ukugembula, ukuqothuka kwebhizinisi noma ukulahlekelwa umsebenzi;
• Abanye: amacala, ukungathembeki, ukuboshwa kwelungu lomndeni, ukulahlekelwa yisenzo somthetho, njll.;
• Izinhlekelele zemvelo njengokuzamazama komhlaba nezikhukhula.

Okokugcina, kufanele kuqashelwe ukuthi izimbangela ezingokomzwelo ze-syndrome azihlali zingalungile ngaso sonke isikhathi: izenzakalo ezingokomzwelo ezinhle zingabangela lesi sifo: iphathi yosuku lokuzalwa emangalisa, iqiniso lokuwina i-jackpot kanye nenhlolokhono yomsebenzi omuhle, njll. Le nhlangano iye yaba ichazwa njenge- "happy heart syndrome".

Ngemuva kwesimo sokuqala se-Takotsubo syndrome, iziguli zisengozini yokuphindeka, noma ngabe sekudlule iminyaka. Izinto ezithile zibonakala zikhombisa ukuthuthuka ekusindeni ngonyaka owodwa nokwehla kwalesi silinganiso sokuphindeka:

• I-ACE inhibitors: ivimbela ukuguqulwa kwe-angiotensin I ibe i-angiotensin II - i-enzyme eyenza imithambo yegazi iqine - futhi ikhulise amazinga e-bradykinin, i-enzyme enemiphumela ye-vasodilating;
• I-Angiotensin II receptor antagonists (ARA II): ivimba isenzo se-eponymous enzyme.
• Umuthi we-antiplatelet (APA) ungase ucatshangelwe esimweni ngasinye ngemva kokulaliswa esibhedlela esimweni sokungasebenzi kahle kwe-ventricular yesokunxele okuhambisana nokuqunjelwa kwe-apical okuqhubekayo.

Indima engaba khona ye-catecholamines eyeqile - izinhlanganisela zezinto eziphilayo ezenziwe ku-tyrosine futhi zisebenza njengehomoni noma i-neurotransmitter, evame kakhulu okuyi-adrenaline, i-norepinephrine ne-dopamine - ekuthuthukisweni kwe-Takotsubo cardiomyopathy kuye kwaphikiswana ngayo isikhathi eside, futhi kanjalo, ama-beta blocker ahlongozwe njengecebo lokwelapha. Kodwa-ke, azibonakali zisebenza isikhathi eside: izinga lokuphindaphinda lika-30% libonwa ezigulini eziphathwa nge-beta-blockers.

Ezinye izindlela zokwelapha zisazocutshungulwa, njengama-anticoagulants, ukwelashwa ngama-hormone kokunqamuka kokuya esikhathini noma ukwelashwa kwengqondo.

Izici eziyingozi ze-Takotsubo syndrome zingahlukaniswa zibe izinhlobo ezintathu eziyinhloko:

• Izici ze-Hormonal: ukugqama kwesiteleka kwabesifazane be-postmenopausal kusikisela ithonya lamahomoni. Amazinga aphansi e-estrogen ngemuva kokunqamuka kokuya esikhathini angakhuphula ukuthambekela kwabesifazane ku-Takotsubo syndrome, kepha idatha ehlelekile ekhombisa ukuxhumana okusobala phakathi kwalaba bantu ishoda kuze kube manje;
• Izici zofuzo: kungenzeka ukuthi ukuthambekela kofuzo kungasebenzisana nezici zemvelo ukuze kuvune ukuqala kwesifo, kepha nalapha futhi, izifundo ezivumela lokhu kugomela ukuthi zenziwe ziyashoda;
• I-Psychiatric and Neurological Disorders: Ukusabalala okukhulu kwengqondo - ukukhathazeka, ukucindezeleka, ukuvimbela - kanye nokuphazamiseka kwezinzwa kuye kwabikwa ezigulini ezine-Takotsubo syndrome.