Onoue Yoshiro, Izumiya Yasuhiro, Takashio Seiji, Ono Takamichi, Morihisa Kenji, Tsujita Kenichi, Yamamoto Eiichiro, Yamamuro Megumi, Kaikita Koichi, Tayama Shinji, Hokimoto Seiji, Sumida Hitoshi, Sugiyama Seigo, Ogawa Hisao
Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University, Japan.
Intern Med. 2012;51(10):1215-9. doi: 10.2169/internalmedicine.51.7196. Epub 2012 May 15.
Shock patients with restrictive cardiomyopathy due to cardiac amyloidosis are refractory to medical treatment. Here, we report a case of early initiation of intra-aortic balloon pumping (IABP) in a patient with cardiac amyloidosis who developed postoperative shock. Continuous hemodiafiltration was also applied to control circulating fluid volume. The mechanical treatments allowed reduction of the doses of catecholamine and diuretics and resulted in full recovery. It is reasonable to initiate IABP and hemofiltration dialysis during the early stages for the appropriate control of hemodynamics and fluid in shock patients with cardiac amyloidosis.
患有心脏淀粉样变性所致限制性心肌病的休克患者对药物治疗无效。在此，我们报告一例心脏淀粉样变性患者术后发生休克后早期启动主动脉内球囊反搏（IABP）的病例。还应用了连续性血液透析滤过以控制循环血容量。这些机械治疗使儿茶酚胺和利尿剂的剂量得以减少，并实现了完全康复。对于心脏淀粉样变性休克患者，在早期启动IABP和血液滤过透析以适当控制血流动力学和液体状况是合理的。
