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Síndrome de Ortner (Ortner syndrome)

Por Paulo Leite 02/04/2018

¨A síndrome de Ortner, também conhecida como síndrome cardiovocal, é uma entidade rara, que pode ser secundária a muitos distúrbios cardiopulmonares (aneurismas aórticos, átrio esquerdo dilatado, artéria pulmonar dilatada e ducto arterial patente). A síndrome de Ortner tem como fisiopatologia o comprometimento do nervo laríngeo recorrente entre a aorta e a artéria pulmonar. Os pacientes geralmente apresentam sintomas de alteração da voz, tosse crônica ou disfonia. A confirmação diagnóstica inclui exames endoscópicos da laringe e tomografia computadorizada do crânio, pescoço e tórax. A avaliação tomográfica visa demonstrar, além das alterações laríngeas, a presença de possíveis lesões no trajeto dos nervos vagos e laríngeos recorrentes, desde a base do crânio até a janela aortopulmonar.¨

■ Unilateral recurrent nerve palsy and cardiovascular disease – Ortner´s syndrome

K Klee, C Eick, R Witlandt et al

Journal of Cardiology Cases 2017, vol 15 (3): 88-90

http://www.journalofcardiologycases.com/article/S1878-5409(16)30084-6/fulltext

■ Ortner syndrome secondary to aortic aneurysm

Alexandre Semionov, John Kosiuk

Radiol Case Rep. 2017 Mar; 12(1): 29–30

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5310539/

■ A rare cause of Ortner´s syndrome: pulmonary artery aneurysm

H Erdogan, F Z Arslan, A Cengiz et al

Clin Med Img Lib 2017, vol 3: 063

https://clinmedjournals.org/articles/cmil/cmil-3-063.php?jid=cmil

■ Cardiovocal syndrome secondary to an aortic aneurysm

Hsing-Won Wang, Mei-Chien Chen, Pin-Zhir Chao, Fei-Peng Lee

Case Rep Otolaryngol. 2016; 2016: 9867942

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4818795/

■ Ortner´s syndrome presenting as thoracic aortic aneurysm mimicking thoracic malignancy: a case report

U Pathirana, S Klularatne, S Handagala et AL

Journal of Medical Case Reports 2015, vol 9: 147

https://jmedicalcasereports.biomedcentral.com/articles/10.1186/s13256-015-0629-1

■ Síndrome de Ortner: relato de caso e revisão da literatura

Dutra, Bruno Landim et al.

Radiol Bras, Aug 2015, vol.48, no.4, p.260-262

http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0100-39842015000400012&lng=en&nrm=iso&tlng=pt

■ Ortner’s Syndrome: Secondary Laryngeal Paralysis Caused by a Great Thoracic Aorta Aneurysm

Zangirolami, Ana Claudia Alves, Oliveira, Frederico Vieira de and Tepedino, Miguel Soares

Int. Arch. Otorhinolaryngol., June 2015, vol.19, no.2, p.180-182

http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1809-48642015000200180&lng=en&nrm=iso

■ Ortner´s: secondary laryngeal paralysis caused by a great thoracic aorta aneurysm

Ana Claudia Alves Zangirolami, Frederico Vieira de Oliveira, Miguel Soares Tepedino

Int Arch Otorhinolaryngol. 2015 Apr; 19(2): 180–182.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4399202/

■ Síndrome cardiovocal (síndrome de Ortner) em um paciente de 16 meses de edad, secundário a un conducto arterioso permeable

R Elizondo-Azuela, A Vizcaíno-Alarcón

An Orl Mex 2015, vol 60: 200-206

http://www.medigraphic.com/pdfs/anaotomex/aom-2015/aom153i.pdf

■ Ortner´s syndrome: a case report and review of the literature

A R Hurtarte Sandoval, R Carlos Zamora, J M Gómez Carrasco, A Jurado Ramos

BMJ Case Rep. 2014; 2014

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4112344/

■ Cardiovocal syndrome – a rare presentation of primary pulmonary hypertension

O Shankar, B V Lohiva

Indian Heart J 2014, vol 66 (3): 375-377

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4121746/

■ Cardiovocal syndrome (Ortner´s syndrome) associated with chronic thromboembolic pulmonary hypertension nd giant pulmonary artery aneurysm: case report and review of the literature

Jaakko Heikkinen, Katrin Milger, Enrique Alejandre-Lafont et l

Case Rep Med. 2012; 2012: 23073

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3477763/

■ Ortner´s syndrome: an unusual cause of cough

C J Grout, K A Simpson, M R Clements

Br J Cardiol 2012, vol 19: 48-49

https://bjcardio.co.uk/2012/03/ortners-syndrome-an-unusual-cause-of-cough/

■ Ascending aortic aneurysm causing hoarse voice: a variant of Ortner´s syndrome

Sinan Robert Eccles, John Banks, Pankaj Kumar

BMJ Case Rep. 2012; 2012: bcr2012007111

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4544936/

■ Unilateral vocal cord paralysis: a review of CT findings, mediastinal causes, and the course of the recurrent laryngel nerves

C M Paquette, D C Manos, B J Psooy

RSNA Radiographics 2012, vol 32 (3)

https://pubs.rsna.org/doi/full/10.1148/rg.323115129

■ Aortic arch patch aortoplasty for Ortner´s syndrome in the age of endovascular stented grafts

Marco L.S. Matteucci, Giuseppe Rescigno, Filippo Capestro, Lucia Torracca

Tex Heart Inst J. 2012; 39(3): 401–404.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3368474/

■ Cardiovocal syndrome (Ortner´s syndrome) associated with chornic thromboembolic pulmonary hypertension and giant pulmonary artery aneurysm: case report and review of the literature

J Heikkinen, K Milger, E Alejandre-Lafont et AL

Case Reports in Medicine 2012, vol 2012 (2012), Article ID 230736, 5 pages

https://www.hindawi.com/journals/crim/2012/230736/

■ Ortner syndrome associated with aortic pseudoaneurysm after repair of aortic coarctation 30 years previously

N Fukunaga, T Koyama, Y Konishi et al

Circulation 2012, vol 125: e937-e938

http://circ.ahajournals.org/content/125/20/e937

■ Giant aortic arch aneurysm and cardio-vocal syndrome: still an open-surgery indication

Jose M. Garrido, Maria Esteban, Juan Lara, Jose F. Rodriguez-Vazquez et al

Cardiol Res. 2011 Dec; 2(6): 304–306

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5358261/

■ Síndrome de Ortner: série de casos e revisão da literatura

Subramaniam, Vijayalakshmi et al

Braz. j. otorhinolaryngol. (Impr.), Oct 2011, vol.77, no.5, p.559-562

http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1808-86942011000500004&lng=en&nrm=iso&tlng=pt

■ Left recurrent laryngeal palsy (Ortner’s syndrome) in schistosomal pulmonary hypertension.

Lambertucci, José Roberto, Prata, Pedro Henrique and Voieta, Izabela

Rev. Soc. Bras. Med. Trop., Oct 2010, vol.43, no.5, p.608-608

http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0037-86822010000500031&lng=en&nrm=iso

■ Ortner´s syndrome: a multifactorial cardiovocal syndrome

S C Plastiras, C Pamboucas, T Zafiriou et al

Clin Cardiol 2010, vol 33 (6):

https://onlinelibrary.wiley.com/doi/abs/10.1002/clc.20646

■ Cardiovocal syndrome: a systematic review

S K Mulpuru, B C Vasavada, G K Punukollu et al

Heart, Lung and Circulation 2008, vol 17: 1-4

http://www.heartlungcirc.org/article/S1443-9506(07)00204-1/pdf

■ Cardiovocal syndrome associated with huge left atrium

O Gulel, D Koprulu, Z kucuksu et al

Circulation 2007, vol 115: e318-e319

http://circ.ahajournals.org/content/115/10/e318

■ Ortner´s syndrome: a radiological diagnosis

C. Bickle, B. E. Kelly, D. S. Brooker

Ulster Med J. 2002 May; 71(1): 55–56.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2475354/

■ by Dr Paulo Fernando Leite

Cardiologia – Centro Médico Unimed BH

Rua Gonçalves Dias 202

Belo Horizonte/MG/Brasil

31 30033306 / 40204020

CRMMG: 7026

Email: pfleite1873@gmail.com

Síndrome de Takotsubo Online (Takotsubo syndrome)

Por Paulo Leite 30/03/2018

¨A síndrome de Takotsubo, originalmente descrita no Japão em 1990, constitui um estado discinético da parede ventricular anterior, apresentando-se clinicamente de forma similar a uma síndrome coronariana aguda, na ausência de lesão obstrutiva significativa. A síndrome de Takotsubo corresponde a uma cardiomiopatia caracterizada por uma disfunção miocárdica transitória afetando ápice do ventrículo esquerdo, que classicamente ocorre após grande estresse físico ou emocional (também chamada “síndrome do coração partido” ou “cardiomiopatia induzida por estresse”). Apesar de a etiologia ainda não ter sido elucidada, seu desencadeamento está ligado a alguns fatores bastante variáveis, sendo o estresse um deles. É provável que sua etiologia seja multifatorial, mas certamente está envolvida uma falha na autorregulação da microvasculatura miocárdica, vasoespasmo coronariano transitório e uma resposta anormal às catecolaminas liberadas em resposta ao estresse⁽³⁾. Há forte predominância no sexo feminino, especialmente entre mulheres na pós-menopausa, de 82% a 100%, com média de idade entre 62 e 75 anos. Todas as situações de estresse apresentam elevação das catecolaminas, que também podem ser causa de disfunção ventricular. O sintoma mais comum é a dor retroesternal; entretanto, alguns pacientes apresentam dispneia, choque ou apenas anormalidades eletrocardiográficas. É, por definição, uma cardiomiopatia adquirida reversível, que – na ausência de outras condições agravantes – costuma ter prognóstico favorável, tendo como tratamento de base o suporte hemodinâmico. ¨

■ Epidemiology, pathogenesis, and management of takotsubo syndrome

Shams Y-Hassan, Per Tornvall

Clin Auton Res. 2018; 28(1): 53–65

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5805795/

■ Reversible left ventricular wall thickening with Takotsubo syndrome sequentially detected by cardiac magnetic resonance imaging

Hideyuki Hayashi, Masahiro Kimura, Takao Kato et al

Intern Med. 2018 Feb 15; 57(4): 517–522

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5849547/

■ Risk stratification using the CHA2DS2-VASc score in Takotsubo syndrome: Data From the Takotsubo Italian Network

Guido Parodi, Fernando Scudiero, Rodolfo Citro, et AL

J Am Heart Assoc. 2017, vol 6(9): e006065

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5634272/

■ Left ventricular in Takotsubo syndrome: incidence, predictors, and management: results from the GEIST (German Italian Stress Cardiomyopathy) registry

Francesco Santoro, Thomas Stiermaier, Nicola Tarantino et AL

J Am Heart Assoc. 2017, vol 6(12): e006990

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5779019/

■ Takotsubo syndrome-associated ventricular standstill in a peripartum patient: case report and review of the literature

Nelson Lee, Kevin Wade Lee, Matthew Michael D’Ambrosio et al

Clin Case Rep. 2018 Feb; 6(2): 283–28

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5799628/

■ Perioperative approach of patient with takotsubo syndrome

Barros, Joana et al.

Rev. Bras. Anestesiol., June 2017, vol.67, no.3, p.321-325

http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0034-70942017000300321&lng=en&nrm=iso

■ Trends in hospitalization for Takotsubo cardiomyopathy in the United States

Rohan Khera, KellyAnn Light-McGroary, Firas Zahr et al

Am Heart J. 2016 Feb; 172: 53–63

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4748175/

■ Seizure associated Takotsubo syndrome: a rare combination

H H Kvi, N A Alhesan, S Upadhaya, S A Hadidi

Case Rep Cardiol 2017; 2017: 8458054

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5546119/

■ Takotsubo cardiomyopathy with a rapidly resolved left ventricular thrombus

A Anabtawi, P C Roldan, C A Roldan

Journal of Investigative Medicine High Impact 2017: 1-5

http://journals.sagepub.com/doi/pdf/10.1177/2324709617734238

■ Cardiac magnetic resonance in Takotsubo syndrome

K Bratis

European Cardiology Review 2017, vol 12 (1)

https://www.ecrjournal.com/takotsubo

■ Optical coherence tomography to evaluate plaque burden and morphology in patients with Takotsubo syndrome

Ingo Eitel, Thomas Stiermaier, Tobias Graf, Christian Möller et al

J Am Heart Assoc. 2016 Dec; 5(12): e00447

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5210410/

■ Evaluation of therapy management and outcome in Takotsubo syndrome

Nadine Abanador-Kamper, Lars Kamper, Judith Wolfertz et al

BMC Cardiovasc Disord. 2017; vol 17: 22

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5561577/

■ Characteristics of coronary microcirculatory functions in patients with Takotsubo syndrome

Giuseppina Novo, Angelo Quagliana, Dario Buccheri, et AL

J Thorac Dis. 2017, vol 9(11): 4531–4537

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5721058/

■ Transient left atrial dysfunction is a feature of Takotsubo syndrome

Thomas Stiermaier, Tobias Graf, Christian Möller et al

J Cardiovasc Magn Reson. 2017; vol 19: 15

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5292816/

■ Age related differences and outcome of patients with Takotsubo syndrome

Aydin Huseynov, Ibrahim El-battrawy, Uzair Ansari et al

J Geriatr Cardiol. 2017 , vol 14(10): 632–638

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5721198/

■ Takotsubo myocardiopathy and hyperthyroidism: a case report and literature review

Darío Rueda, Rafael Aguirre, Damián Contardo et al

Am J Case Rep. 2017; 18: 865–870

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5560469/

■ Síndrome de tako-tsubo, caracterización clínica y evolución a un año plazo

Ugalde, Héctor et a

Rev. méd. Chile, Oct 2017, vol.145, no.10, p.1268-1275

https://scielo.conicyt.cl/scielo.php?script=sci_arttext&pid=S0034-98872017001001268&lng=es&nrm=iso

■ Subsequent safe pregnancy with cesarean delivery in a patient with a history of peripartum Takotsubo syndrome complicated by cardiogenic shock

Rodolfo Citro, Michele Bellino, Flora Minichino et AL

J Cardiovasc Echogr. 2017, vol 27(3): 114–11

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5516443/

■ An uncommon manifestation of shock: Takotsubo syndrome

Ying X Gue, Sanjay S Bhandari, Mubarak Ahamed

Echo Res Pract. 2017, vol 4(4): K41–K4

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5633058/

■ Miocardiopatía Takotsubo postparto: parto distócico como posible factor desencadenante.

Frías Sánchez, Zoraida et al.

Rev. chil. obstet. ginecol., Dic 2016, vol.81, no.6, p.520-52

https://scielo.conicyt.cl/scielo.php?script=sci_arttext&pid=S0717-75262016000600012&lng=es&nrm=iso

■ Clinical and echocardiographic analysis of patients suffering from recurrent Takotsubo cardiomyopathy

Ibrahim El-Battrawy, Uzair Ansari, Michael Behnes et al

J Geriatr Cardiol. 2016 Nov; 13(11): 888–893

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5253404/

■ Desfecho de Curto e Longo Prazo na Cardiomiopatia Induzida por Estresse: O que Podemos Esperar?.

Ribeiro, Vania Filipa Andrade et al.

Arq. Bras. Cardiol., Jan 2014, vol.102, no.1, p.80-85

http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0066-782X2014000100011&lng=en&nrm=iso

■ Pseudoinfarto agudo do miocárdio devido à síndrome da disfunção ventricular apical transitória (síndrome de Takotsubo).

Maciel, Bruno Araújo et al.

Rev. bras. ter. intensiva, Mar 2013, vol.25, no.1, p.63-67

http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0103-507X2013000100012&lng=en&nrm=iso

■ Takotsubo cardiomyopathy: a rare, but serious, complication of epileptic seizures

Rocha, João et al.

Arq. Neuro-Psiquiatr., Mar 2013, vol.71, no.3, p.195-197

http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0004-282X2013000300195&lng=en&nrm=iso

■ Síndrome de takotsubo após hemorragia subaracnoidea

Wajnberg, Eduardo

Radiol Bras, Abr 2012, vol.45, no.2, p.132-134

http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0100-39842012000200016&lng=en&nrm=iso

■ Síndrome de Takotsubo: a propósito de un caso

Molero Silvero, E. et al.

Sanid. Mil., Set 2012, vol.68, no.3, p.168-171

http://scielo.isciii.es/scielo.php?script=sci_arttext&pid=S1887-85712012000300007&lng=es&nrm=iso

■ Síndrome de Tako-Tsubo: caso clínico

Rau, Carlos M et al

Rev. méd. Chile, Mar 2011, vol.139, no.3, p.348-352

https://scielo.conicyt.cl/scielo.php?script=sci_arttext&pid=S0034-98872011000300010&lng=es&nrm=iso

■ Síndrome do coração partido (Síndrome de Takotsubo) induzida por ecocardiograma de estresse com dobutamina.

Vasconcelos Filho, Francisco Juarez Cruz de et al.

Arq. Bras. Cardiol., Jul 2009, vol.93, no.1, p.e5-e

http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0066-782X2009000700014&lng=en&nrm=iso