Dyspnea is a common symptom in patients presenting to the emergency department. It has a variety of causes that range from non-urgent to life-threatening. One episode of dyspnea in a healthy young person is easy to overlook. However, if the symptoms occur after physically or emotionally stressful events, careful evaluation needs to be undertaken because it may be associated with Takotsubo syndrome, which is rarely expected but can be fatal. Herein, we report the case of Takotsubo syndrome in a healthy young woman who arrived at the emergency department after experiencing a short single episode of dyspnea following a minor surgery. A 23-year old woman with no underlying chronic disease underwent closed reduction surgery for a nasal bone fracture under general anesthesia (with sevoflurane as the anesthetic). Approximately 5 h later, she presented to the emergency department with dyspnea, which improved soon upon arrival at the emergency department. There were no other symptoms. The dyspnea occurred about 5 h after being discharged on observation, with an uneventful postoperative course. Her electrocardiogram and chest X-ray findings were unremarkable. On testing, troponin I and creatine kinase myocardial band levels were elevated at 6.122 ng/mL and 11.2 µg/L (reference ranges: 0.000–0.046 ng/mL and 0.0–5.0 µg/L), respectively. Bedside echocardiography revealed an ejection fraction of 25%, with mid-ventricular and apical akinesia and basal hyperkinesia. The pulmonary and coronary angiographic computed tomographic scans were unremarkable. Hence, apical Takotsubo syndrome was suspected. A follow-up echocardiogram taken 5 days after admission showed full recovery with a normalized ejection fraction (60%) and no regional wall motion abnormality. The patient was discharged on the sixth day with no other complications. When atypical symptoms, such as transient dyspnea, manifest, it becomes necessary to suspect and diagnose Takotsubo syndrome to ensure timely and appropriate medical management, especially when a preceding stressful event, such as minor surgery has occurred. It might be helpful to perform bedside point-of-care echocardiography to check for regional wall motion abnormalities that are typically associated with Takotsubo syndrome.

中文翻译：

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Takotsubo 综合征是年轻女性单次呼吸困难的一个被忽视和难以捉摸的原因：病例报告

呼吸困难是急诊科患者的常见症状。它有多种原因，从非紧急到危及生命。健康年轻人的一次呼吸困难很容易被忽视。但是，如果症状出现在身体或情绪紧张事件之后，则需要进行仔细评估，因为它可能与 Takotsubo 综合征有关，这种情况很少发生，但可能是致命的。在此，我们报告了一名健康年轻女性的 Takotsubo 综合征病例，她在小手术后经历了短暂的单次呼吸困难发作后到达急诊室。一名没有潜在慢性疾病的 23 岁女性在全身麻醉（七氟醚作为麻醉剂）下因鼻骨骨折接受了闭合复位手术。大约 5 小时后，她因呼吸困难到急诊科就诊，到达急诊科后很快好转。没有其他症状。出院后观察约5 h出现呼吸困难，术后过程平稳。她的心电图和胸部 X 光检查结果不显着。在测试中，肌钙蛋白 I 和肌酸激酶心肌带水平分别升高 6.122 ng/mL 和 11.2 µg/L（参考范围：0.000–0.046 ng/mL 和 0.0–5.0 µg/L）。床边超声心动图显示射血分数为 25%，伴有心室中部和心尖部运动不能和基底运动过度。肺部和冠状动脉血管造影计算机断层扫描无异常。因此，怀疑心尖Takotsubo综合征。入院 5 天后进行的超声心动图随访显示完全恢复，射血分数正常化（60%），无局部室壁运动异常。患者于第六天出院，无其他并发症。当出现非典型症状（例如短暂性呼吸困难）时，有必要怀疑和诊断 Takotsubo 综合征，以确保及时和适当的医疗管理，特别是当先前的压力事件（例如小手术）发生时。进行床旁床旁超声心动图检查通常与 Takotsubo 综合征相关的局部室壁运动异常可能会有所帮助。显然，有必要怀疑和诊断 Takotsubo 综合征，以确保及时和适当的医疗管理，特别是当先前的压力事件发生时，例如小手术。进行床旁床旁超声心动图检查通常与 Takotsubo 综合征相关的局部室壁运动异常可能会有所帮助。显然，有必要怀疑和诊断 Takotsubo 综合征，以确保及时和适当的医疗管理，特别是当先前的压力事件发生时，例如小手术。进行床旁床旁超声心动图检查通常与 Takotsubo 综合征相关的局部室壁运动异常可能会有所帮助。