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黄蜂蜇伤后迟发性支架内血栓形成。

Late stent thrombosis after wasp sting.

作者信息

Işık Turgay, Tanboğa Ibrahim Halil, Ayhan Erkan, Uyarel Hüseyin

机构信息

Department Cardiology, Balıkesir University Faculty of Medicine, Balıkesir, Turkey.

出版信息

Turk Kardiyol Dern Ars. 2012 Oct;40(7):620-2. doi: 10.5543/tkda.2012.41882.

Abstract

Myocardial infarction (MI) following a bee sting is a highly unusual reaction. A 65-year-old man allergic to honeybee venom was admitted to the emergency department suffering from a wasp sting with urticaria. The patient had a history of bare metal stent (BMS) 9 months previously with regular drug use. He experienced chest pain after the sting and electrocardiography revealed ST-segment elevation in the chest leads. Subsequently, the patient developed ventricular tachycardia disrupting hemodynamics. Sinus rhythm was obtained by cardioversion. Coronary angiogram revealed total stent thrombosis (ST) in the midportion of the left anterior descending coronary artery. Primary coronary intervention was successfully performed. Presence of shared pathways in allergic reaction and MI pathogenesis may be responsible for de novo or ST. To our knowledge, this is the first case of total occlusive late ST in BMS following a wasp sting.

摘要

蜂蜇后发生心肌梗死(MI)是一种极不寻常的反应。一名对蜂毒过敏的65岁男性因黄蜂蜇伤伴荨麻疹入住急诊科。该患者9个月前有裸金属支架(BMS)置入史且规律用药。蜇伤后他出现胸痛,心电图显示胸导联ST段抬高。随后,患者发生室性心动过速,血流动力学紊乱。通过心脏复律恢复窦性心律。冠状动脉造影显示左前降支冠状动脉中段完全支架血栓形成(ST)。成功进行了冠状动脉介入治疗。过敏反应和MI发病机制中共同途径的存在可能是新发血栓或支架血栓形成的原因。据我们所知,这是黄蜂蜇伤后BMS发生完全闭塞性晚期支架血栓形成的首例病例。

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