Wassef Nancy, Khan Nazish, Munir Shahzad
Department of Cardiology, Royal Wolverhampton Hospital, Wolverhampton, UK.
Department of Pharmacy, Royal Wolverhampton Hospital, Wolverhampton, UK.
BMJ Case Rep. 2015 Jan 9;2015:bcr2014207151. doi: 10.1136/bcr-2014-207151.
An 18-year-old man diagnosed with attention-deficit hyperactivity disorder was recently started on quetiapine in addition to regular methylphenidate, which he had been taking for a number of years. He presented with chest pain and inferolateral ST elevation, and underwent urgent coronary angiography, which showed normal coronary arteries. The initial troponin level was raised and an inpatient echocardiogram showed mild left ventricular systolic dysfunction with no evidence of regional wall motion abnormality. Cardiac MRI showed subepicardial late gadolinium enhancement, which was suggestive of myocarditis. Quetiapine and methylphenidate were discontinued and the patient was discharged home after 1 week. He was followed up within 8 weeks with complete recovery and no symptoms.
一名18岁被诊断患有注意力缺陷多动障碍的男性,除了多年来一直服用的常规哌甲酯外,最近开始服用喹硫平。他出现胸痛和下侧壁ST段抬高,接受了紧急冠状动脉造影,结果显示冠状动脉正常。最初肌钙蛋白水平升高,住院期间的超声心动图显示左心室轻度收缩功能障碍,无节段性室壁运动异常的证据。心脏磁共振成像显示心外膜下晚期钆增强,提示心肌炎。停用了喹硫平和哌甲酯,患者1周后出院回家。8周内进行随访,患者完全康复且无症状。