Esber Christopher, Breathett Khadijah, Sachak Taha, Moore Stephen, Lilly Scott M
Department of Internal Medicine, The Ohio State University Wexner Medical Center, Columbus, Ohio, USA.
Department of Internal Medicine, Division of Cardiology, The Ohio State University Wexner Medical Center, Columbus, Ohio, USA.
Cardiol Res. 2014 Aug;5(3-4):108-111. doi: 10.14740/cr325w. Epub 2014 Jul 20.
A 47-year-old woman with breast cancer suffered progressive chest pain and flushing within 5 minutes of her second exposure to paclitaxel. Her symptoms progressed and she became pulseless. Advanced cardiac life support (ACLS) was initiated, and after a series of chest compressions the cardiac monitor revealed ventricular fibrillation. With ongoing ACLS she was transferred to the emergency department where she regained a pulse. Review of electrocardiogram revealed prominent ST elevation in leads V1, V2 and V3 with reciprocal ST depression. She was transferred urgently to the catheterization laboratory. Angiography revealed a high-grade stenosis in the proximal left anterior descending artery (LAD), and drug-eluting stents were placed without complications. She was then transferred to the floor and shortly thereafter suffered pulseless electrical activity and died despite prolonged attempts at resuscitation. Herein, we describe the development of acute myocardial infarction after paclitaxel administration, discuss potential etiologies and review evidence for an allergic component.
一名47岁的乳腺癌女性在第二次使用紫杉醇后5分钟内出现进行性胸痛和潮红。她的症状逐渐加重，随后脉搏消失。启动了高级心脏生命支持（ACLS），经过一系列胸外按压后，心脏监护仪显示为心室颤动。在持续进行ACLS的情况下，她被转至急诊科，在那里恢复了脉搏。心电图检查显示V1、V2和V3导联ST段显著抬高，并有对应的ST段压低。她被紧急转至导管室。血管造影显示左前降支近端（LAD）存在高度狭窄，置入药物洗脱支架，未出现并发症。随后她被转至病房，不久后出现无脉电活动，尽管进行了长时间的复苏尝试仍死亡。在此，我们描述了紫杉醇给药后急性心肌梗死的发生情况，讨论了潜在病因，并回顾了过敏因素的相关证据。
