Dubois F, Charlier P, Solal A C, Passa P, Gourgon R
Service de cardiologie, hôpital Bichat, Paris.
Arch Mal Coeur Vaiss. 1989 Dec;82(12):2071-4.
The authors report a case of primary hyperparathyroidism in a 47 year old woman presenting with cardiac arrhythmias. She had paraoxystic supraventricular tachycardias and rate-dependent ventricular hyperexcitability suggestive of a catecholamine-induced phenomenon which were resistant to antiarrhythmic therapy over a 3 year period; the plasma calcium concentration was 3.30 mmol/l. An ectopic parathyroid adenoma was removed surgically, normalising the biological changes, and no further arrhythmias were detected by Holter monitoring during the 2 year follow-up period. The association of atrial and ventricular arrhythmias seems to be relatively rate in hyperparathyroidism; patients usually present with atrioventricular block and ventricular hyperexcitability. The other cardiovascular abnormalities observed in hyperparathyroidism are hypertension and myocardial hypertrophy. The electrophysiological mechanisms underlying the clinical manifestations remain obscure.
作者报告了一例47岁患有心律失常的女性原发性甲状旁腺功能亢进症病例。她患有阵发性室上性心动过速和心率依赖性心室过度兴奋性，提示为儿茶酚胺诱导的现象，在3年期间对抗心律失常治疗耐药；血浆钙浓度为3.30 mmol/L。通过手术切除了异位甲状旁腺腺瘤，使生物学改变恢复正常，在2年随访期内动态心电图监测未检测到进一步的心律失常。甲状旁腺功能亢进症中心房和心室心律失常的关联似乎相对较少见；患者通常表现为房室传导阻滞和心室过度兴奋性。在甲状旁腺功能亢进症中观察到的其他心血管异常是高血压和心肌肥厚。临床表现背后的电生理机制仍不清楚。
