Furrer F, Giambarba C
Interdisziplinäre Intensivstation, Stadtspital Waid Zürich.
Praxis (Bern 1994). 2012 Jul 4;101(14):919-22. doi: 10.1024/1661-8157/a000989.
A couple of days after increasing the dosage of betaadrenergic- and adding calcium channel blockers due to an increased heart rate in atrial fibrillation, a 77 year old female was found in cardiogenic shock. After exclusion of further causes a therapy with catecholamines, calcium, high dose insulin and phosphodiesterase inhibitors was initiated. Despite this combined therapy the shock persisted. Only after administration of levosimendan, a calcium sensitizer, a normalization of the heart function could be observed. We discuss the danger of combining drugs with negative inotropic properties for rate control in atrial fibrillation and review the therapy with focus on the effects on cardiac cells of all recommended drugs in the treatment of intoxication with betareceptor- and calcium channel blockers.
在因房颤心率加快而增加β肾上腺素能药物剂量并加用钙通道阻滞剂几天后，一名77岁女性出现心源性休克。在排除其他病因后，开始使用儿茶酚胺、钙剂、高剂量胰岛素和磷酸二酯酶抑制剂进行治疗。尽管采用了这种联合治疗，休克仍持续存在。仅在给予钙增敏剂左西孟旦后，才观察到心功能恢复正常。我们讨论了在房颤心率控制中联合使用具有负性肌力特性药物的风险，并着重回顾了针对β受体阻滞剂和钙通道阻滞剂中毒治疗中所有推荐药物对心肌细胞作用的治疗方法。
