Kumagai Naoto, Dohi Kaoru, Tanigawa Takashi, Ito Masaaki
Department of Cardiology and Nephrology, Mie University Graduate School of Medicine, Tsu, Japan.
BMJ Case Rep. 2013 Nov 22;2013:bcr2013201544. doi: 10.1136/bcr-2013-201544.
A 71-year-old man suddenly collapsed and went into cardiopulmonary arrest. The cardiopulmonary resuscitation attempt succeeded in restoration of spontaneous circulation. The initial 12-lead electrocardiogram showed inferior acute myocardial infarction (AMI). The patient was initially diagnosed as having cardiogenic shock associated with inferior AMI. In spite of early coronary revascularisation, bradycardia and hypotension were sustained. After termination of sedation and extubation, he was found to have a quadriplegia and diagnosed with a cervical spinal cord injury (SCI). Therefore, the patient was finally diagnosed with neurogenic shock caused by acute cervical SCI due to the traumatic injury preceded by loss of consciousness complicating inferior AMI. We should recognise that SCI has unique haemodynamic features that mimic those associated with inferior AMI, but requires very different treatment.
一名71岁男性突然晕倒并发生心肺骤停。心肺复苏尝试成功恢复了自主循环。最初的12导联心电图显示下壁急性心肌梗死（AMI）。患者最初被诊断为与下壁AMI相关的心源性休克。尽管早期进行了冠状动脉血运重建，但心动过缓和低血压仍持续存在。在镇静终止和拔管后，发现他四肢瘫痪，并被诊断为颈脊髓损伤（SCI）。因此，该患者最终被诊断为由急性颈SCI引起的神经源性休克，其原因是意识丧失之前的创伤性损伤并发下壁AMI。我们应该认识到，SCI具有独特的血流动力学特征，与下壁AMI相关的特征相似，但需要非常不同的治疗方法。
