D'Aloia A, Faggiano P, Fiorina C, Vizzardi E, Cavaliere S, Foccoli P, Bignotti T, Dei Cas L
University of Brescia.
Monaldi Arch Chest Dis. 2003 Jan-Mar;59(1):88-90.
Laser bronchoscopy is a usually well tolerated procedure for the treatment of obstructive lesions on the tracheobronchial tree, with a very low morbidity and mortality rate. Cardiovascular complications, including atrial and ventricular arrhythmias, and myocardial ischemia, have only rarely been reported during laser bronchoscopy. Cardiac arrhythmias during such a procedure are usually well tolerated but occasionally may be life threatening. Here we report a case of a young, female patient affected by Pulmonary Tuberculosis with a cicatricial stenosis of the left main bronchus who developed an episode of prolonged cardiac arrest due to ventricular fibrillation (and no signs of acute myocardial ischemia) during rigid broncoscopic laser-therapy. Underlying Coronary Artery Disease and other cardiac abnormalities were also excluded by subsequent cardiovascular examination. The clinical implications are also discussed.
激光支气管镜检查是治疗气管支气管树阻塞性病变的一种通常耐受性良好的操作，发病率和死亡率极低。心血管并发症，包括房性和室性心律失常以及心肌缺血，在激光支气管镜检查期间仅有极少的报道。在此类操作过程中发生的心律失常通常耐受性良好，但偶尔可能危及生命。我们在此报告一例年轻女性肺结核患者，其左主支气管存在瘢痕性狭窄，在硬质支气管镜激光治疗期间因室颤（且无急性心肌缺血迹象）发生了长时间心脏骤停。随后的心血管检查也排除了潜在的冠状动脉疾病和其他心脏异常情况。本文还讨论了其临床意义。
