Viveiros Eulália, Aveiro Ana Cristina, Costa Edite, Nunes José Luis
Department of Pediatrics, Hospital Central do Funchal, Funchal, Portugal.
BMJ Case Rep. 2013 Jun 3;2013:bcr2012008440. doi: 10.1136/bcr-2012-008440.
We describe a case of a healthy male full-term neonate, 21 days old, admitted to the emergency room, presenting a severe cardiovascular collapse with an initial sinus rhythm. The first diagnostic hypothesis was of septic shock, having antibiotics, fluid resuscitation, inotropic drugs and ventilatory support started immediately. After achieving haemodynamic stability, a new cardiovascular collapse occurred with supraventricular tachycardia (SVT). The latter was successfully treated and the neonate did not suffer any organ damage. Cardiogenic shock should be considered despite being a much rarer cause of shock in neonates. SVT is promptly diagnosed when a cardiorespiratory monitor is available; however, the intermittent occurrence of the tachycardia episodes makes this diagnosis more difficult to recognise and manage.
我们描述了一例21天大的健康足月男婴,因严重心血管功能衰竭被送入急诊室,初始心律为窦性。首要诊断假设为感染性休克,立即开始使用抗生素、液体复苏、强心药物和通气支持。在血流动力学稳定后,又出现了伴有室上性心动过速(SVT)的心血管功能衰竭。后者得到成功治疗,新生儿未出现任何器官损伤。尽管心源性休克在新生儿休克中是一种罕见得多的病因,但仍应予以考虑。当有心脏呼吸监测仪时,室上性心动过速可迅速诊断;然而,心动过速发作的间歇性使得这种诊断更难识别和处理。