Monterrubio Villar J, Fernández Bergés D, Alzugaray Fraga R J, Veiga M D, Córdoba López A, Corcho Díaz G
Unidad de Medicina Intensiva, Hospital Comarcal de Don Benito-Villanueva, Badajoz.
Rev Esp Cardiol. 2000 Mar;53(3):467-70. doi: 10.1016/s0300-8932(00)75111-6.
We present a case of a sixty-nine-year-old male admitted to the hospital because of an acute respiratory failure that needed intubation and mechanical ventilation. Shortly after several attempts of right and left (the last one successful) subclavian vein cannulation (the last one successful) he developed a bilateral tension pneumothorax with important hemodynamic repercussion, a critical hypoxia and an ST elevation in inferior leads. Other more typical electrocardiographic changes could be observed: decrease in QRS amplitude and diminishing of precordial R voltage. After removing the air of the right pleural space, all the electrocardiographic signs disappeared returning to normal without electric or enzymatic assay of myocardial necrosis.
我们报告一例69岁男性患者，因急性呼吸衰竭入院，需要进行气管插管和机械通气。在多次尝试右、左锁骨下静脉置管（最后一次成功）后不久，他出现了双侧张力性气胸，并伴有严重的血流动力学影响、严重缺氧以及下壁导联ST段抬高。还可观察到其他更典型的心电图变化：QRS波振幅降低和胸前导联R波电压减小。在排出右侧胸腔内的气体后，所有心电图征象均消失，恢复正常，未进行心肌坏死的电或酶学检测。
