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脓毒症诱发的可逆性心肌病的提示。

A reminder of sepsis-induced reversible cardiomyopathy.

作者信息

Lin Aung Naing, Shaikh Atif, Lin Sithu, Misra Deepika

机构信息

Department of Internal Medicine, The Brooklyn Hospital Center, Brooklyn, New York, USA.

Department of Cardiology, The Brooklyn Hospital Center, Brooklyn, New York, USA.

出版信息

BMJ Case Rep. 2017 Jul 18;2017:bcr-2017-220556. doi: 10.1136/bcr-2017-220556.

Abstract

Cardiomyopathy is a progressive disease of myocardium causing either mechanical or electrical disturbances. Sepsis-induced cardiomyopathy (SICM) is an entity of cardiomyopathy which is reversible in 1â€"2 weeks after recovery from sepsis or septic shock. SICM is thought to have unpredictable cumulative mortality towards sepsis but its exact mechanism remains elusive. We report a case of SICM in a 63-year-old woman presented with sudden onset of dyspnoea on exertion and orthopnoea following nausea, vomiting and diarrhoea after consuming Chinese foods. Transthoracic echocardiogram revealed severely reduced global left ventricular ejection fraction (LVEF) of <20% which returned back to normal LVEF of 57% after 10 days. Subsequent cardiac catheterisation showed non-obstructive coronaries. No specific therapy intended for reversal of SICM presents to date despite current sepsis survival guideline available for haemodynamic support. Initiation of beta blockers after recovery from septic shock has been beneficial.

摘要

心肌病是一种导致心肌机械或电活动紊乱的进行性疾病。脓毒症诱发的心肌病(SICM)是心肌病的一种类型,在从脓毒症或脓毒性休克恢复后的1至2周内是可逆的。SICM被认为对脓毒症具有不可预测的累积死亡率,但其确切机制仍不清楚。我们报告一例63岁女性的SICM病例,该患者在食用中餐后出现恶心、呕吐和腹泻,随后突发劳力性呼吸困难和端坐呼吸。经胸超声心动图显示左心室整体射血分数(LVEF)严重降低,<20%,10天后恢复至正常LVEF的57%。随后的心脏导管检查显示冠状动脉无阻塞。尽管目前有脓毒症生存指南提供血流动力学支持,但迄今尚无旨在逆转SICM的特异性治疗方法。脓毒性休克恢复后开始使用β受体阻滞剂已显示有益。

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A reminder of sepsis-induced reversible cardiomyopathy.脓毒症诱发的可逆性心肌病的提示。
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本文引用的文献

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Takotsubo Cardiomyopathy and Sepsis.应激性心肌病与脓毒症
Angiology. 2017 Apr;68(4):288-303. doi: 10.1177/0003319716653886. Epub 2016 Sep 29.

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