Thanaviratananich Sikawat, Katirji Bashar, Alshekhlee Amer
*Department of Neurology, SSM Neurosciences Institute and St. Louis University, St. Louis, MO; and †Neurological Institute, University Hospitals Case Medical Center, Cleveland, OH.
J Clin Neuromuscul Dis. 2014 Mar;15(3):90-5. doi: 10.1097/CND.0000000000000022.
Myocardial pathology is rarely associated with myasthenia gravis (MG). We describe a case of newly diagnosed MG with decompensated heart failure [stress-induced cardiomyopathy (SICM)] that occurred during the crisis phase.
Case report and review of literature.
A 42-year-old woman underwent chemotherapy followed by a transsternal resection of a malignant epithelioid thymoma invading the pericardium. A month after surgical resection, she developed progressive oropharyngeal symptoms with respiratory distress requiring tracheal intubation. Cardiac evaluation on the day of admission showed a normal ejection fraction, which rapidly decreased to 15% on the second hospital day and recovered to 45% after 1 week. Review of the literature revealed 4 myasthenic patients who developed SICM in the crisis phase; all improved with treatment.
SICM may occur in MG crisis, especially in the presence of malignant thymoma. All previous cases including our patient had improved myocardial function and clinical outcomes.
心肌病变很少与重症肌无力（MG）相关。我们描述了1例在危象期发生失代偿性心力衰竭[应激性心肌病（SICM）]的新诊断MG病例。
病例报告及文献复习。
1例42岁女性接受了化疗，随后经胸骨切开切除侵犯心包的恶性上皮样胸腺瘤。手术切除1个月后，她出现进行性口咽症状并伴有呼吸窘迫，需要气管插管。入院当天的心脏评估显示射血分数正常，在住院第2天迅速降至15%，1周后恢复至45%。文献复习发现4例重症肌无力患者在危象期发生了SICM；所有患者经治疗后均有改善。
SICM可能发生在MG危象中，尤其是存在恶性胸腺瘤时。包括我们的患者在内，之前所有病例的心肌功能和临床结局均有改善。
