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全身麻醉诱导期间的应激性心肌病

Takotsubo syndrome during induction of general anaesthesia.

作者信息

Jabaudon M, Bonnin M, Bolandard F, Chanseaume S, Dauphin C, Bazin J E

机构信息

Department of Anaesthesia and Intensive Care, Hôtel-Dieu, CHU Clermont-Ferrand, France.

出版信息

Anaesthesia. 2007 May;62(5):519-23. doi: 10.1111/j.1365-2044.2007.05061.x.

Abstract

A 77-year-old female was admitted in our hospital for uterine prolapse surgery. She developed ventricular tachycardia during induction of general anaesthesia and after initial symptomatic measures, she was transferred to the coronary care unit. Heart failure persisted and electrocardiographic changes mimicking acute myocardial infarction appeared. Coronary angiography was normal and left ventriculography revealed akinesis of the apical region of the left ventricle and apical ballooning during systole, with relative sparing of the base of the heart. Complete recovery of left ventricular function occurred 8 days after the initial onset of symptoms. A diagnosis of Takotsubo syndrome was made on the basis of consistent clinical and laboratory findings, typical echocardiography and angiography findings, and reversible course. This case emphasises the importance of being aware of uncommon causes of cardiac dysfunction in stressful situations, especially during induction of general anaesthesia.

摘要

一名77岁女性因子宫脱垂手术入住我院。她在全身麻醉诱导期间出现室性心动过速,经初步对症处理后,被转至冠心病监护病房。心力衰竭持续存在,且出现了类似急性心肌梗死的心电图变化。冠状动脉造影正常,左心室造影显示左心室心尖区域运动减弱,收缩期心尖部气球样膨出,心脏基底部相对未受累。症状首次出现8天后左心室功能完全恢复。根据一致的临床和实验室检查结果、典型的超声心动图和血管造影表现以及可逆病程,诊断为Takotsubo综合征。该病例强调了在应激情况下,尤其是全身麻醉诱导期间,认识到心脏功能障碍不常见原因的重要性。

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